Children's Hospital Colorado

Clubfoot

What is clubfoot?


What are the types of clubfeet?
Clubfoot is a deformity of the foot, also known as talipses equinovarus. Clubfoot is the most common orthopedic condition that babies are born with, occurring in 6 in 1,000 live births.

A child with clubfoot has an abnormally positioned foot that causes him or her to turn the ankle inward and walk on the toe and outside edge of the foot. It can involve one or both feet as well as the ankle and leg bones, joints muscles and tendons.

In the majority of cases, the cause of clubfoot is unknown and is called “idiopathic clubfoot.” This type of clubfoot is known to run in families.

Other types of clubfoot include syndromic clubfeet, which are usually associated with a condition that involves other parts of the body; and neurogenic clubfeet, which are the least common and are usually the result of a spinal cord abnormality.

What are the signs and symptoms of clubfoot?

The word “club” is sometimes used to describe the appearance of the foot. The affected foot/feet can range from relatively flexible to stiff and rigid.

Helpful resources:

Ponseti International Association
A leader in training and educating parents and doctors on the treatment of clubfoot.

nosurgery4clubfoot
An online support group for parents to discuss non-surgical methods of treating clubfoot.

Clubfoot Shoe Exchange
A Facebook group for parents to exchange Ponseti-method shoes.

How is clubfoot diagnosed?

A diagnosis is usually made during a prenatal ultrasound, and other times it is diagnosed at birth. Once the condition is diagnosed, your pediatrician will recommend that you see a pediatric orthopedic specialist.

At Children’s Hospital Colorado, we see expecting parents for prenatal consultations and also during the first few weeks after a baby is born. When you visit us for the first time, we will:

  • Provide a history of clubfoot
  • Develop a treatment plan
  • Start treatment

How is clubfoot treated?

Most clubfeet can be corrected with serial casting, bracing and little or no surgery. The Clubfoot Program at Children’s Colorado follows the “Ponseti” Method.

The Ponseti Method is recognized throughout the world as the Gold Standard for the treatment of Club foot. Dr. Ponseti’s method is broken into two phases. The first phase is called the Treatment Phase and consists of a (weekly) series of specific serial manipulations (gentle stretching), casting and tenotomy of the Achilles tendon. The second phase known as the Maintenance Phase is the initiation of abduction bracing of the feet for up to five years.

When to make your first appointment

We like to start treatment within two weeks after the baby is born, because their feet can bend and stretch more easily. However, we can start treatment on older children as well.

Casting

At Children's Colorado, we apply a series of casts on a weekly basis to slowly correct the deformities. Casting allows us to gradually stretch the foot into a more correct position. Most of the deformity corrects with four to seven casts, but more complex patients may require more casting.

What is an Achilles tenotomy procedure?

Not all patients require a tenotomy, but most do in order to completely correct the clubfoot. This procedure (called an “Achilles tenotomy”) lengthens the Achilles tendon. This can usually be done during an outpatient visit with a local anesthetic. After the Achilles tenotomy procedure, your child’s foot will be casted for two to four weeks.

Bracing

How long will my child wear a brace?

After casting, bracing is required to maintain the correction. Braces with special shoes for both feet (even if only one foot is affected) keep the feet in the correct position.

Initially, the brace is worn full-time for two to three months, and then only at night for up to five years. During the bracing time, our physical therapists instruct parents on stretching and tickling exercises that are to be performed daily to help strengthen and maintain the correction.

Why choose Children’s Colorado for clubfoot treatment?

Treatment of clubfoot requires patience and an experienced pediatric orthopedist, like the experts in the Orthopedics Institute at Children’s Hospital Colorado. If treatment is not done correctly and in sequence, other deformities of the foot may occur.

We offer a team approach

The clubfoot team at Children's Colorado believes that teamwork allows us to provide the best care for our patients. Our multidisciplinary clinic consists of the following:

  • Orthopedic surgeons
  • Physician assistants
  • Physical therapists
  • Nursing staff
  • Orthotists with Prosthetic & Orthotic Group
  • Cast technicians
  • Staff assistants

A specialized program dedicated to kids with clubfeet

Prenatal consultations for the expectant parents and familyThe Clubfoot Program at Children's Colorado evaluates and treats patients, from newborn through teenagers, diagnosed with clubfoot. Our Clubfoot Program provides:

  • A designated clubfoot clinic with multidisciplinary care
  • Multiple providers for family convenience

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