Club feet in children
Clubfoot is a defect of the foot in children that is typically present since birth. The risk of clubfoot increases significantly when there is another family member who suffered from the same (20-30 times more likely). Clubfoot occurs in approximately one of 1000 births. In most cases, the cause of clubfoot is not known. There appears to be an interruption of the normal development of the foot before birth. Many normal infants have abnormally shaped feet after birth that can be easily placed in a normal position by an examiner. These cases are not true clubfoot, but the result of compression in the uterus. Persistence of the abnormal shape after three months of age likely represents a true abnormality. X-ray performed at this time may be helpful. Treatment may begin within the first week of life with bracing and casting. If bracing or casting is not successful by several months of age, the child made need surgical correction.
What is clubfoot?
Many newborn infants are born with hands and feet in abnormal positions. This is due to compression within the uterus prior to birth. For cases where the foot cannot be easily placed in a normal position by an examiner, there may be an underlying defect of muscle and bone. This is called clubfoot.
How is clubfoot diagnosed?
Diagnoses of mild clubfoot by prenatal ultrasound may be difficult due to normal compression of the extremities in a confined uterus. After birth, severe cases may be obvious. Because abnormal bending of the feet and hands after birth is common, an examiner should attempt to place the foot in a normal position. If this is performed easily the child most likely does not have clubfoot. A foot abnormality that persists beyond three months of age is more likely to be a true abnormality (i.e., clubfoot).
How is clubfoot treated?
Initial treatment involves repositioning the foot and applying a brace or cast. This is typically repeated every week for several months. If this technique is not successful by several months of age, surgical correction may be considered.
What are the long-term complications of clubfoot?
- Most children regain relatively normal function of the foot.
- Mild weakness and decreased range of motion of the foot are common.
Photo credit - CDC/James W. Hanson, M.D. date: 1973