What is Clubfoot?

Clubfoot (Congenital Talipes Equinovarus) is a congenital foot deformity resulting from abnormal development of muscles, tendons and bones inutero.  It occurs in about 1 in every 1000 births.  We do not understand the exact cause of clubfoot but there is thought be an underlying genetic component.  In families where one child is affected with clubfoot, the chances of having a child that is also affected is about 1 in 30.  For most children with standard clubfoot treated with current methods, they generally go on to lead active, healthy lives.  In the developing world however, clubfoot is still a very significant cause of disability.

How is clubfoot treated?

Clubfoot in an otherwise normal child is usually responsive to serial manipulation and casting using Ponseti method.  This method was developed by Dr Ignacio Ponseti several decades ago and has been used widely for treatment in the last 10-15 years internationally.  Treatment begins in the first couple of weeks after birth and involves serial casting every 7 days.  The ligaments, joint capsules, and tendons are stretched under gentle manipulations.  The bones are brought into correct position to allow for remodelling and growth.  Most feet require 5-7 casts to achieve correction.

 Ponseti casting sequence over 6 weeks

Ponseti casting sequence over 6 weeks

 

Once an appropriate correction is obtained, the child then wears boots and bars full-time initially and then part-time for a few years.  Non-compliance with bracing is the most frequent reason for relapse or recurrence of clubfoot.  Some patients require some minor surgery for fine-tuning of the foot once more growth occurs in childhood.

 Mitchell Boots and Bar - appropriate wear is crucial to maintaining the correction

Mitchell Boots and Bar - appropriate wear is crucial to maintaining the correction

Recommended resources:

Ponseti guide for parents

See "Clubfoot Mommas" on Facebook (note this is a closed group).

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