What is it?
Clubfoot describes a range of foot and ankle abnormalities. The defects can be mild or severe and can affect one or both feet. An affected foot points downward, with the toes turned in. If both feet are affected, as they are in about half of all cases, the toes will turn in toward each other rather than pointing straight ahead. The foot bones, ankle joints, and ligaments of the foot may be abnormal or tight, making it difficult to bring the foot into a normal position. There are also milder foot abnormalities that may appear similar to clubfoot.
How common is it?
Clubfoot is one of the most common birth defects. Each year, about 5,000 U.S. babies are born with the most severe forms of clubfoot. Clubfoot is almost twice as likely to affect boys. Milder forms of foot malformation are even more common and tend to affect both sexes equally. In most cases, doctors can't pinpoint what causes clubfoot. It was once thought that the malformations were caused by a twisted or cramped position in the mother's womb. But many scientists today believe clubfoot starts early in pregnancy, probably around the 10th week of gestation. Heredity and some environmental factors, such as smoking during pregnancy, are likely at the root of the defect.
How is a child affected?
Clubfoot is not painful in infancy. The child is not affected until he tries to stand or walk. Without treatment, the poorly aligned foot and ankle can't move normally, resulting in an awkward gait. If both feet are affected, the child may walk on the balls of his feet or on another part of the foot such as the side or top. This can result in sores and hard calluses and may even interfere with the growth of the entire leg.
What are the treatments?
The disabling effects of clubfoot can be avoided with early treatment. Generally, treatment will begin soon after birth. The most common treatment is a series of casts, which gradually train the foot to stay in the proper position. It can take three to six months of casting to straighten the foot. Other cases will require surgery to place the bones in proper position and to open and lengthen joints. This surgery often takes place around the age of 6 months. Because clubfoot can recur, frequent checkups during the first seven years of life are recommended.