About clubfoot

aboutCongenital clubfoot is one type of a lower leg deformity of unidentified causes (see Reasons that clubfoot occurs) that occurs in otherwise healthy infants. It is one of the most common congenital disorders.

Clubfoot causes the foot to turn inward and point downward. Shortened tendons and ligaments on the inside of the lower leg restrict outward movement and cause the foot to turn inward. Tight Achilles tendons cause the foot to point downward.

Clubfoot is now generally thought to develop after the first trimester of pregnancy and can sometimes be picked up on ultrasound from about 20 weeks. It can be either unilateral (one foot) or bilateral (both feet) clubfoot.

In Caucasians, the rate of occurrence is about one per 1000 births (some sources say 1:750). In South African blacks it occurs three times as frequently and in Polynesians, six times as frequently. It occurs about twice as frequently in boys.

The congenital clubfoot appears to be of genetic origin, but no one is entirely sure what causes it. Some families report having a history of it, but in others it is apparently an isolated case.

If you have a clubfoot your chance of having a baby with clubfoot is increased; if one parent is affected with clubfoot, there is a three to four percent chance that the offspring will also be affected. When both parents have clubfoot, their children have a 15% chance of developing clubfoot. In one study it was concluded that if a family already has one baby with clubfoot, the chance of having another increases to 1 in 35.

Clubfoot must be corrected in order for the child to walk properly. It is not difficult to correct. However, which treatment to use has been a subject of controversy for over 150 years. Although surgery became more popular than manipulation and serial casting during the1950′s, there is now a growing demand for non-surgical techniques, particularly the Ponseti Method.

Dr Ponseti says in his book:

“A well-conducted orthopaedic treatment, based on a sound understanding of the functional anatomy of the foot and on the biological response of young connective tissue and bone to changes in direction of mechanical stimuli [correct manipulation of the foot ligaments, joint capsules, and tendons followed by casting in the new position] can gradually reduce or almost eliminate these deformities in most clubfeet. Less than five per cent of infants with very severe, short, fat feet with stiff ligaments unyielding to stretching will need surgical correction. The parents of all other infants may be reassured that their baby, when treated by expert hands, will have a functional, plantigrade foot which is normal in appearance, requires no special shoes, and allows fairly good mobility.”

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