What is Clubfoot?

  • Clubfoot is a relatively innocent birth defect that affects the position of the babies feet.
  • Here, the feet are turned inwards( toe of both feet turning towards each other)
  • At birth, it does not affect their development, but once the child starts standing and walking( 8-12 months) it causes problems.
  • The condition can be corrected over few months with regular physiotherapy and occasionally surgical intervention.
  • Clubfoot is also called as CTEV.

CAUSES

Most times the cause cannot be identified. The risk factors include

  • It can run in families( genetic)
  • It can happen if it is muscular or nerve development defect( ex.spine problems)

DIAGNOSIS

  • May be detected by anomaly scan ( ultrasound at 20 weeks gestation)
  • After birth, the diagnosis can be made by assessing the position of the foot ( toe inwards). The foot is passively moved at birth to see the range of movements.

MANAGEMENT

  • The treatment should start early at birth( first week or 2nd week of life)
  • Most times the baby’s leg can be easily moved in all directions in spite of the defect. These cases are managed by the physiotherapist who will ask you to regularly manipulate the foot towards the correct position. You may have to do this repeatedly ( every time you feed the child, that is 3 to 4 hourly) for months and be reviewed by the physiotherapist regularly ( weekly).
  • These corrective movements are not painful to the baby.
  • If the defect is more prominent than the child’s leg is put in the right position and then a cast is put for a few weeks( 6 to 8 weeks), so the leg can develop in the desired way.
  • Occasionally surgical intervention is suggested where the tendons( structures stabilizing joint) are operated to fix the joint in required position.
  • To assist these measures the child may also be given special boots to keep the foot steady for the first few years
  • Most children respond to the treatment in the first few months and rarely require surgery.
  • The child may have to be assessed by a medical professional for physical growth parameters like standing, walking.
  • Inadequate repair of the clubfoot may in later years affect the posture and the growth of other joints like the knee joint and hip joint.

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