Clubfoot
Definition
Clubfoot is a condition that involves both the foot and lower leg in which the foot turns inward and downward. It is a congenital condition, which means it is present at birth.
Alternative Names
Talipes equinovarus; Talipes
Causes
Clubfoot is the most common congenital disorder of the legs. It can range from mild and flexible to severe and rigid.
The cause is not known. Most often, it occurs by itself. But the condition may be passed down through families in some cases. Risk factors include a family history of the disorder and being male. Clubfoot can also occur as part of an underlying genetic syndrome, such as trisomy 18.
A related problem, called positional clubfoot, is not true clubfoot. It results from a normal foot positioned abnormally while the baby is in the womb. This problem is easily corrected after birth.
Symptoms
The physical appearance of the foot may vary. One or both feet may be affected.
The foot turns inward and downward at birth and is difficult to place in the correct position. The calf muscle and foot may be slightly smaller than normal.
Exams and Tests
The disorder is identified during a physical examination.
A foot x-ray may be done. Ultrasound during the first 6 months of pregnancy can also help to identify the disorder.
Treatment
Treatment may involve moving the foot into the correct position and using a cast to keep it there. This is often done by an orthopedic specialist. Treatment should be started as early as possible, ideally, shortly after birth, when it is easiest to reshape the foot.
Gentle stretching and recasting will be done every week to improve the position of the foot. Generally, 5 to 10 casts are needed. The final cast will stay in place for 3 weeks. After the foot is in the correct position, the child will wear a special brace nearly full time for 3 months. Then, the child will wear the brace at night for 3 to 5 years.
Often, the problem is a tightened Achilles tendon, and a simple procedure is needed to release it.
Some severe cases of clubfoot will need surgery if other treatments do not work, or if the problem returns. The child should be monitored by your health care provider until the foot is fully grown.
Outlook (Prognosis)
The outcome is usually good with treatment.
Possible Complications
Some defects may not be completely fixed. However, treatment can improve the appearance and function of the foot. Treatment may be less successful if the clubfoot is linked to other birth disorders.
When to Contact a Medical Professional
If your child is being treated for clubfoot, contact your provider if:
- The toes swell, bleed, or change color under the cast
- The cast appears to be causing significant pain
- The toes disappear into the cast
- The cast slides off
- The foot begins to turn in again after treatment
References
Martin S. Clubfoot (talipes equinovarus). In: Copel JA, D'Alton ME, Feltovich H, et al. Obstetric Imaging: Fetal Diagnosis and Care. 2nd ed. Philadelphia, PA: Elsevier; 2018:chap 64.
Warner WC, Beaty JH. Paralytic disorders. In: Azar FM, Beaty JH, eds. Campbell's Operative Orthopaedics. 14th ed. Philadelphia, PA: Elsevier; 2021:chap 34.
Winell JJ, Davidson RS. The foot and toes. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 694.
Review Date:11/6/2023
Reviewed By:Neil K. Kaneshiro, MD, MHA, Clinical Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997-A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
The Agency for Health Care Administration (Agency) and this website do not claim the information on, or referred to by, this site is error free. This site may include links to websites of other government agencies or private groups. Our Agency and this website do not control such sites and are not responsible for their content. Reference to or links to any other group, product, service, or information does not mean our Agency or this website approves of that group, product, service, or information.
Additionally, while health information provided through this website may be a valuable resource for the public, it is not designed to offer medical advice. Talk with your doctor about medical care questions you may have.
Health Outcome Data
No data available for this condition/procedure.
