Club foot, also known as talipes equinovarus, is most commonly recognized as a deformity in one foot or both. The unusual condition is congenital, which means it is present at birth, and symptoms can range from mild or severe. Here is a look at everything you need to know about club foot including its symptoms, causes, diagnosis, and treatment.
Club Foot Symptoms
The characteristics of club foot can vary depending on the person. However, common symptoms include a foot that is smaller than normal, a foot that points downward, a foot that points excessively inward, or a foot that points outward. In more rare and severe cases, the bottom of the foot can turn up as well.
Fortunately, the condition is known to be painless for infants, but it can cause discomfort and limited mobility once walking begins. If not treated, the affected leg will often develop as shorter and smaller than the other. This discrepancy will become more apparent as the child grows.
Club Foot Causes
Club foot occurs in around 1 in every 1,000 births, which makes it a fairly common condition. However, the cause is idiopathic, which means that it is currently unknown. There are, however, some theories that suggest the condition can be caused by genetics.
Club foot has also been linked to other conditions, such as spina bifida. In other cases, environmental factors may play a role. For example, smoking cigarettes during pregnancy, especially if there is a family history of the defect, increases the chances of having a baby with club foot.
Club Foot Risk Factors
Although the cause is unknown, there are some factors that can increase the chances of club foot in infants. These include:
- A family history of club foot
- Being male
- Smoking while pregnant
- An inadequate amount of amniotic fluid during pregnancy
- Contracting an infection or using drugs during pregnancy
Club Foot Diagnosis
Club foot is diagnosed at birth when the defect is visible. In some cases, however, an ultrasound may be able to detect club foot before a child is born.
Once confirmed after birth, an X-ray may be ordered to determine how the skeletal structures of the foot are positioned. However, X-rays are not always helpful, because an infant’s foot and ankle have yet to fully ossify. In other words, they have not fully hardened yet and don't show up well on X-rays because of this.
Club Foot Treatment
The most common method for treating club foot is the Ponseti Method, in which an orthopedic specialist treats the affected foot by reshaping it. Using a cast, the foot is moved into the correct position for healthy development.
Stretching and casting are done weekly, and it usually takes 5 to 10 sessions for success—the last cast remains in place for 3 weeks. Once this process is complete, the child will need to wear a brace full-time for three months. After this initial period, the brace is worn only when the child is sleeping for the next three years.
Another method known as the French Method reshapes the foot with the aid of a physical therapist. This method involves daily stretching and manipulation of the foot into the correct position, where it is then taped in order to preserve the range of motion that has been achieved. Finally, the leg is then placed in a plastic splint.
A physical therapist appointment is needed three times a week, but this method should be practiced daily by the parents. After 3 months, the physical therapist visits are reduced, but the daily regimen will need to continue until the child is two or three years old.
Surgery is often required following either method in order to lengthen the child's tightened Achilles tendon. Luckily, the procedure is minor and easy to perform. However, in more extreme cases, serious surgery may be necessary. This is usually the case if casting does not fully treat the club foot or if the defect returns after casting.