Clubfoot is a genetic disorder in which one or both of your baby's feet curve inward. When you look at their feet, the bottom often looks sideways or even upward. Clubfoot is also known as “talipes equinovarus”. Clubfoot is a common congenital disorder (existing from birth). As per research, approximately one out of every 1,000 infants will develop clubfoot.
There are two types of clubfoot:- Isolated or idiopathic clubfoot is the most prevalent kind. Isolated clubfoot occurs when a child has clubfoot but no other medical concerns. Idiopathic indicates that the reason for clubfoot is unknown.
- Non-isolated clubfoot occurs in conjunction with other health problems. These diseases include arthrogryposis (a joint issue) and spina bifida (a neural tube defect). Neural tube problems affect your baby's brain, spine, and spinal cord.
What Are The Symptoms Of Clubfoot?
The most typical indication of clubfoot is one or both feet twisting inward. Your baby's foot is facing the opposite leg.You may also see that their foot has:- Kidney form
- Deep creases on the interior
- Higher arch than usual (known as cavus foot deformity)
Other clubfoot symptoms that you may observe are:- Smaller calf muscle in the afflicted leg
- Shorter foot
- Ankle stiffness
- Their feet do not have a complete range of motion
Researchers don't know what causes clubfoot. It is most likely a mix of genetics and environment.- Genetics: Genes control how your child's body looks, grows, and functions. A defect with one or more genes (passed down from parents to offspring) might cause clubfoot.
- Environment: Drug use and smoking during pregnancy may increase the likelihood of having a baby with a birth abnormality such as clubfoot.
Who Is At Risk Of Congenital Clubfoot?
Babies assigned male at birth (AMAB) have up to double the risk of developing clubfoot as babies assigned female at birth (AFAB). A family history of clubfoot puts your infant at an increased risk.Moreover, babies are prone to:- Another birth abnormality, such as spina bifida or cerebral palsy
- A genetic disorder, such as Trisomy 18 (Edward syndrome)
A person may be more likely to have a child with clubfoot if they:- Had oligohydramnios throughout pregnancy. This is a result of insufficient amniotic fluid, which surrounds the foetus
- Zika infection during pregnancy may result in birth abnormalities and other complications
- Smoked, drank or took recreational drugs while pregnant
Clubfoot is not painful for your infant. Many newborns will not notice it during the first few months of life. However, clubfoot will make it difficult to stand and walk. It will not disappear on its own. Babies with clubfoot need treatment to repair the condition before they reach walking age.Untreated clubfoot may lead to the following:- Babies with clubfoot may walk in unique ways. People often walk on their soles and bottoms. An infant with clubfoot may walk on the sides and tops of its feet.
- Foot infections
- Foot issues, especially calluses. A callus is a thick layer of skin that often forms on the soles of the feet.
- A joint condition called arthritis may cause pain, stiffness, and swelling
When And How Is Clubfoot Diagnosed?
Many times, a healthcare practitioner may identify clubfoot during a prenatal ultrasound. A prenatal ultrasound provides images of the developing foetus. If your doctor diagnoses clubfoot during pregnancy, you may begin arranging for the therapy your child will need after delivery.In certain cases, your provider may diagnose clubfoot after your baby is delivered. They'll normally find it during your baby's initial physical checkup. In certain situations, your doctor may order an X-ray to confirm the diagnosis.Management & Treatment
When Should Clubfoot Therapy Begin?
Healthcare professionals advise treating clubfoot as soon as feasible. Early treatment helps your child prevent future difficulties. It is ideal to start therapy during your baby's first two weeks of life.Who Treats Clubfoot?
Your infant will most likely need a team of healthcare experts to treat clubfoot, including:- Paediatric orthopaedists specialise in bone and joint issues in children
- An orthopaedic surgeon specialises in bone and joint surgery
- A physical therapist can help your child gain strength and move their foot
Clubfoot therapy consists of numerous treatments. Your care team will explore the alternatives with you and determine which is best for your child. Treatments include:- The Ponseti procedure involves stretching and casting your child's leg to straighten the curvature
- The French approach involves stretching and splinting their limb to straighten the curvature
- Bracing involves wearing specific shoes to maintain the foot at the right angle
- Surgery may be a possibility if other approaches are ineffective
What Are The Risks Of Having Clubfoot Surgery?
The risks of congenital clubfoot surgery are:- Nerve damage
- Infection
- Bleeding
- Stiffness
What's The Outlook For Newborns With Clubfoot?
Clubfoot won't go away on its own. Early therapy is vital for a successful result. Babies that start therapy early have better outcomes. They can walk, run, and play in conventional shoes without any discomfort. They are even capable of participating in sporting activities.If just one foot was injured, you may see that:- The damaged foot is smaller and less mobile compared to the unaffected foot.
- The calf muscles of the leg with clubfoot may be smaller.
- Your youngster may get weary or complain of hurting legs sooner than children without clubfoot.
- The afflicted leg may be somewhat shorter. However, this seldom causes severe issues.
- If your child has another ailment in addition to clubfoot, the prognosis may be determined by how the other illness is treated.
What Should You Do To Help Your Child With Their Braces?
Regularly wearing the brace increases your child's chances of success. However, it might be difficult for youngsters to wear the brace for so many hours each day. These recommendations might assist parents in simplifying the process of wearing braces.- Play with your youngster while they are wearing their brace. Practice mild movements and kicking games. Use the bar to assist bend and straighten their knees.
- After the first three months, your child will only require the brace at night and during naps. Make the brace a part of their sleep regimen. They will learn that sleeping requires wearing a brace.
- A soft cushion on the metal bar makes the brace more comfortable for both your child and you. It also helps to safeguard your home's furnishings and appliances.
- Creams and lotions may exacerbate skin conditions. It's normal to see some redness on your child's foot. However, blisters may indicate that the heel is sliding out of the brace. Make sure the shoes are tightly strapped on so the foot does not slide. Check your child's foot periodically to ensure that blisters do not develop.
- Sometimes the foot slips out of the brace. Make sure the strap is tight. Double socks may also assist in holding the shoe securely on the foot. A physical therapist might propose additional actions to ensure the shoe fits snugly on the foot.
What Should I Ask The Doctor About Clubfoot?
Ask your child's doctor for a referral to an orthopaedic surgeon who specialises in the Ponseti procedure. This therapy requires a high degree of proficiency and competence. If your care team advised the French approach, get a referral to a physical therapist who specialises in that practice.Other questions to ask your child's carer include:- When should my infant begin treatment?
- What is the best way to treat my baby's clubfoot?
- How long will the therapy last?
- Will my child walk normally?
- How can I keep clubfoot from returning?
When you see anything unusual about your foetus or infant, you may question what to do next. You've spent your whole pregnancy fantasising about the adorable dresses you'd dress your baby in, not the casts, splints, and braces they'd have to wear. However, clubfoot is a common congenital condition, and treatment is extremely effective. It is critical to adhere to the treatment regimen precisely. This enhances the odds of success. With the proper therapy, many children with clubfoot may walk, run, and even participate in sports without discomfort. Consult your child's healthcare practitioner about the appropriate rehabilitation strategy for their clubfoot.FAQs on Understanding Clubfoot: Diagnosis, Risk Factors, and Management
- Can clubfoot be prevented?Good healthcare before and throughout pregnancy ensures that your child has the greatest possible start in life. Even before you get pregnant, you should decide if a preconception exam is appropriate for you. During this appointment, a healthcare expert ensures that you are in the best possible health while pregnant. If you are at high risk of having a child with clubfoot or other birth abnormalities, see a genetic counsellor.
- Can Clubfoot return?Clubfoot may return. It is more likely to occur if the treatment plan is not followed properly. If the foot returns to the clubfoot position, consult your child's doctor. You may need to repeat some steps of the treatment strategy.
Disclaimer: Medically approved by Dr Deepak Mulchandani, Consultant, Paediatrics & Neonatology, P D Hinduja Hospital & Medical Research Centre, Khar
