Club Foot

Club foot is a common foot deformity present at birth where in one or both the feet are turned towards an inward and downward position. It is more common in boys than girls. It is also called as talipes equinovarus.

Club foot is of two types:

• Postural or positional club foot – This occurs as a result of abnormal positioning of the fetus in the mother’s womb. The foot is flexible and can be moved to a near normal position after birth.
• Rigid or fixed club foot – In rigid form, the foot is rigid or stiff as the muscles at the back of the lower leg become very tight.

Although club foot does not cause any pain, it can affect the physical appearance and the child’s ability to walk. Children with club foot may have abnormal foot where,

• Foot may be slightly smaller than the normal
• The front of the foot may be twisted toward the other foot
• Stiff muscles in the lower leg which may affect range of motion

The exact cause of clubfoot is unknown. Genetic and environmental factors may have a role in developing the condition. Other congenital malformations such as spina bifida may also cause club foot.

Treatment options include:

Stretching and Casting – It is also known as the Ponseti method. The foot is manipulated into a correct position and a cast is placed to maintain that position. Repositioning and recasting is repeated for every 1 to 2 weeks for 2 to 4 months, each time bringing the foot toward the normal position. After realignment of the foot, it is maintained through splinting with braces to keep the foot in the corrected position. The brace is worn for 3 months following which it is worn only at night for up to 3 years, to maintain the correction.

Club foot repair – It is surgical repair of the birth defect which involves lengthening or shortening the tendons (tissues that help attaches muscles to bones) of the foot.

Osteotomy – It is a surgical procedure where a part of the bone is cut to shorten or lengthen its alignment. The procedure involves removal of a wedge shaped bone located near the damaged joint and the remaining bones are joined together and secured using the staples or pins.

Fusion or arthrodesis – It is a surgical procedure where two or more bones are joined or fused together. Bone for fusion will be taken from other parts in the body. Metal pins or plates may be used to hold the bones in position.