A clubfoot is a relatively common disorder of the foot that is typically present at birth. The presence of a clubfoot at birth can be a source of distress for the parents. It could be part of a syndrome of other problems or it could just be an isolated deformity that just affects both or one foot. A clubfoot is usually apparent and easy to diagnose.
The treatment of a clubfoot depends on if it an isolated deformity or part of a syndrome of other conditions. Usually and typically, the isolated idiopathic clubfoot which is more flexible is treated with what is called the Ponseti approach. The more rigid clubfoot or the clubfoot associated with other conditions are typically treated with a surgical approach.
With the Ponseti protocol to treat clubfoot the doctor will typically move and manipulate the baby’s foot into a more correct position and then place the foot into a cast to hold it in that more corrected position. On a weekly basis for several months the foot will be further manipulated and moved into an improved position to keep trying to move the foot towards a more normal corrected position and the cast reapplied to hold it there for another week. Often there may have to be a minor surgical procedure to lengthen the Achilles tendon as that is often so tight. This percutaneous Achilles tenotomy will typically be done towards the end of this process of the manipulation and casting. When a more normal foot shape and alignment is achieved, there are several things that need to be done to help keep that alignment. This will include continuing to do stretching exercises. Special shoes and braces may need to be worn for up to a few years.
If the deformity is more rigid or the manipulation and casting approach does not work, then complex surgical procedures are often done to correct the clubfoot.