Clubfeet and their Treatment

November 7, 2012
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Staying in the thread of pediatric conditions, clubfoot is a deformity that should be addressed.  Although it is rarely seen in adolescents and adults in our country, it occurs in about 1 in every 1000 births.  Fortunately, it is recognized very early and treated immediately when seen in the United States.  With immediate appropriate treatment, a person born with clubfoot can expect to walk normally without residual effects.

Clubfoot is when the front of the foot has turned in and wrapped itself around the back of the foot so that if the child were to walk, they would have to bear weight on the thin skin of the top of the foot rather than the thick skin on the bottom of the foot.  The foot is described as being shaped like the letter “C” turned in on itself.  Clubfoot is a deformity seen with some neurological disorders, but more often it is seen simply due to lack of room.  The lack of space pushes the feet up against the wall of the uterus.  When the baby is born, the deformed feet are easily recognized.

Fortunately, a baby’s body is very flexible after it is born, and remains very flexible while the mother is breast feeding.  This flexibility allows us to mold a clubfoot back into proper position without major surgery.  Starting as soon as possible, the baby is put into a series of casts, removed and reapplied each week, which will slowly bring the foot back around so that it will eventually function as a normally.  Within 12 weeks, a severely deformed foot can look completely normal.  The body’s ability to adapt and remodel is incredible at that young age, and we can take advantage of this by immediate treatment.  The babies who do the best are the ones who are treated only hours to days after birth.  If treatment is delayed for weeks or months, the baby may not be flexible enough to resolve the entire deformity.  If this is encountered, surgery may be required for correct the problems.

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