My child has a clubfoot, what can I do?


A clubfoot is one of the most common birth abnormalities, and can be corrected without surgery if it is treated early. — TNS

Dear Mayo Clinic: I am 24 weeks pregnant and underwent an ultrasound that discovered my child has a clubfoot. I am worried about my child’s life and function with this diagnosis. What is this condition and are there any new treatment advances that my baby can benefit from?

First, congratulations on having a baby.

It is certainly an exciting time, but understandably, it can be stressful when you hear that your child has something that might make him or her different.

Clubfoot is a common diagnosis that occurs in one in 1,000 births, making it among the most common birth abnormalities.

The biggest fear for parents is that the quality of life for their child born with a clubfoot will be limited.

They worry if their child will be able to run, jump and play like their peers.

With the correct treatment, your child could have a normal quality of life.

Children who are born with a clubfoot may have other relatives who were also born with one.

Mostly, these children only have a clubfoot, and no other problems with their bones, joints or muscles.

However, there are a few genetic syndromes that have clubfoot associated with them, such as arthrogryposis and spina bifida.

These syndromes are best explored with the help of medical geneticists to offer a comprehensive genetic evaluation and determine if additional challenges may be in your child’s future.

While clubfoot can affect both feet, it is more common on one side of the body.

Having clubfoot may cause your child’s foot to be slightly less flexible – and a different shoe size from the unaffected foot – but over time, your child should be able to walk normally with appropriate care.

Both surgical and non-surgical options are available to treat clubfoot.

As your child grows, a gait analysis may be performed to assess future surgical needs in order to maximise function.

Left untreated, clubfoot causes more serious problems, including arthritis and other orthopaedic issues related to an awkward gait.

The primary method used to correct clubfoot in children is known as the Ponseti method.

This is a series of long-legged casts that are changed weekly.

It is important to seek out an orthopaedic specialist knowledge- able in this condition, as well as a cast technician skilled at placing and removing casts weekly, to get the correction required.

At the end of the casting, many children must undergo a small surgery at the heel to release the tightness at the Achilles tendon.

Sometimes, this procedure is performed in the casting area itself.

Other times, it is done in the operating room.

After the casting and small Achilles tendon surgery is complete, a foot brace is worn full-time for three months, followed by part-time wear until the child reaches the age of three.

Close collaboration with prosthetic and orthotic experts ensures the braces are comfortable.

Unfortunately, even with strict brace adherence, the clubfoot can sometimes return.

Measuring your child’s foot pressure can give early warning that the clubfoot is returning.

This will enable the child to undergo less surgery than if a corrective procedure is delayed.

This small surgery is successful in allowing children with clubfoot to keep up with their peers.

Looking ahead, your child should be able to have a normal quality of life and range of motion.

Finding a healthcare provider and expert you are comfortable with will be important.

Also, being committed to treatment and being diligent with follow-up should mean your child with clubfoot will be able to run, jump and play just like his or her peers. – By Dr Todd Milbrandt/Mayo Clinic News Network/Tribune News Service

Dr Todd Milbrandt is an orthopaedic surgeon in the United States.

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