A foot deformity that children are born with, clubfoot occurs in approximately 1 out of every 1,000 births. There is not a direct cause for clubfoot, though it does have tendency to run in families. The affected foot will appear turned in and pointed down when compared to the other foot. With appropriate treatment, most children will be able to participate in regular activities.
Treatment begins within the first six weeks of life. Treatment includes placing a plaster cast from the child’s foot to thigh. This cast is removed every week, the foot is gently molded, and a new cast is placed. About 6 casts are applied total to correct the inward position of the foot; however, some children require a greater number of casts. Most children will need a small surgery, called an Achilles tenotomy, after casting to allow proper foot movement. This procedure involves cutting the heel cord (tendon in the back of the heel), allowing it to heal in a lengthened position so the child can move the foot up and down. After the procedure, a cast is applied for 3-4 weeks then bracing is used to prevent recurrent deformity. It is important to keep the cast clean/dry, and check for any skin changes, toe discoloration or change in foot temperature.
Some children will need additional casting and/or tenotomy to correct deformity recurrence. Occasionally, casting and bracing will not correct the child’s clubfoot. Surgery may be necessary to adjust the tendons, ligaments, and bones in the foot to correct the deformity.