Reasons that clubfoot occurs
In pinpointing the specific cause of clubfoot, the condition is classified into four types: congenital, teratologic, syndrome complex, or positional. The information on this site is about congenital clubfoot. The four types are determined by the cause as follows:
- Congenital clubfoot is by far the most common form of clubfoot and is also referred to as “idiopathic” clubfoot, meaning that the condition arises spontaneously from an unknown cause. A child with congenital clubfoot has no other abnormalities, and the clubfoot is an isolated incident. The condition occurs more frequently within certain families, prompting scientists to believe that genetics play an important role in causing congenital clubfoot.
- Teratologic clubfoot occurs as a part of an underlying neuromuscular disorder, such as spina bifida or arthrogryposis multiplex congenita. Clubfoot may or may not be present in children with these disorders. Teratologic clubfoot often is severe and nearly always requires surgery to achieve correction.
- Syndrome complex clubfoot occurs when a child is born with one of a number of genetic disorders, and clubfoot is part of the bigger disorder. Children with chromosomal abnormalities such as Down syndrome may also have syndrome complex clubfoot.
- Positional clubfoot occurs when an otherwise normal foot is held in a deformed position in utero, and thus is “moulded” incorrectly. A small uterus, the presence of twins and abnormal foetal position have all been associated with positional clubfoot, although many such pregnancies result in babies without clubfoot. Positional clubfoot responds readily to non-surgical treatments, such as splinting and casting. Because positional clubfoot is not an inherent defect, but instead a “packaging” problem, some physicians do not consider it a true clubfoot.
1. American College of Foot and Ankle Surgeons
2. Congenital Clubfoot. Fundamentals of treatment, by Ignacio V. Ponseti (Oxford University Press, 1996)