Children's Hospital Colorado

Clubfoot (Talipes Equinovarus)

What is clubfoot?

A young girl with blonde hair and wearing a pink coat is sitting on an exam table with her leg propped up on the table in a purple cast.

Clubfoot (also known as talipes equinovarus) is a deformity of the foot present at birth that impacts one or both feet. A child with clubfoot has an abnormally positioned foot that causes the child to turn their ankle inward, to the point where it almost touches the inside of the leg.

What causes clubfoot (talipes equinovarus)?

At this time there is no known cause for clubfoot, but it is does run in families.

What are the types of clubfoot?

There are three different types of clubfoot:

  1. Idiopathic: the most common type of clubfoot, in which the cause is unknown
  2. Syndromic: usually associated with a condition that involves another part of the body
  3. Neurogenic: usually a result of a spinal cord abnormality or other neurologic disorder

Who gets clubfoot?

Clubfoot is the most common congenital (present at birth) pediatric orthopedic condition in children, and it occurs in about 6/1,000 live births. Most of the time, the diagnosis of clubfoot is made on a prenatal ultrasound, or shortly after birth.

What are the signs of clubfoot?

Clubfoot is identified when the foot or both feet are rotated internally at the ankle towards the calf of the opposite leg, with the toes pointing down and a notable crease at the mid foot. A tight Achilles tendon (the tendon that connects the calf muscle to the heel bone) is also noted.

What tests are used to diagnose clubfoot?

Clubfoot is most commonly detected on a prenatal ultrasound or shortly after birth. No specific tests are used to diagnose the condition.

How do providers at Children’s Hospital Colorado make a diagnosis?

In the majority of cases, clubfoot is diagnosed on a prenatal ultrasound. If clubfoot is not noted on a prenatal ultrasound, it can be easily diagnosed after birth by looking at the feet.

Why choose Children’s Colorado for clubfoot treatment?

The Clubfoot Program at Children’s Hospital Colorado is comprised of experts that treat clubfoot patients using the Ponseti Method (considered to be the gold standard of treatment) from birth to teenage years.

Our multidisciplinary team works together to ensure each patient receives the appropriate attention and treatment for proper correction of the deformity. Our providers are “Ponseti” trained, which means we do not perform surgery for clubfoot and instead focus on gentle manipulation and casting.

What to expect from clubfoot treatment?

Clubfoot is not uncommon, but it is known to cause increased stress and anxiety for the expecting parents. Our prenatal consultations are designed to educate and prepare parents for the treatment plan that will be started once their baby has arrived. We also hope it will help decrease some of the anxiety related to clubfoot.

If treatment is not done correctly and in the proper order, other deformities of the foot may occur. Successful treatment of clubfoot requires an experienced orthopedic team, like our experts at the Orthopedic Institute at Children’s Hospital Colorado.

How is clubfoot treated?

Our treatment options for clubfoot include:

    1. Serial casting: The foot is gradually stretched into a correct position and then held in place with casts. These casts are changed in clinic once a week for about 6-8 weeks.
    2. Tenotomies (tendon lengthening): In the majority of cases, after we have corrected as much of the foot as possible through casting; your child may require a heel cord (Achilles) tenotomy. A tight Achilles tendon prevents the foot from being flat. Achilles tenotomies are often done in the clinic, but in some cases may be done in the operating room where your child will be placed under anesthesia (medicine that makes them sleep). During a tenotomy, a surgeon will divide the tendon into two so that new tendon can grow in the space that’s left behind. This procedure helps improve the ankle joint's range of motion.
    3. Bracing: After we have obtained the correct position, it is necessary to maintain the correction. Braces hold the feet in the correct position. Braces are typically worn full time for 3-4 months, then at night and during naps for up to 5 years.
    4. Stretching: Along with bracing, it is very important that your child does daily stretching exercises. These exercises will be taught by a member of our team during your child’s clinic visits.

Why choose Children’s Hospital Colorado for your child’s clubfoot?

The Clubfoot Program at Children’s Hospital Colorado evaluates and treats patients, from newborn through the teenage years, diagnosed with clubfoot. Our Ponseti-trained specialists consistently practice the International Gold Standard for clubfoot treatment.

Our Clubfoot Program consists of a multiple multidisciplinary team of orthopedic surgeons, physician assistants, physical therapists, orthopedic technicians and registered nurses who are dedicated to helping children with clubfoot to obtain the best outcome.

Our Clubfoot Program provides:

    1. A designated clubfoot clinic with a multidisciplinary care team
    2. Multiple providers at all satellite clinic locations for family convenience
    3. Prenatal consultations for the expectant mother and her family

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