Club foot

What is club foot?

Club foot, also called congenital talipes equinovarus (CTEV), is a fairly common condition present at birth.

Club foot happens when the tendons that connect the leg muscles to the foot are shorter than usual, causing the foot to turn inward and downward. This makes it look like it has been rotated internally at the ankle. The foot points downwards and inwards, with the soles of the feet facing backwards.

The condition can be mild or severe and may affect one foot (unilateral club foot) or both feet (bilateral club foot). Both feet are affected in around half of the children born with the condition.

Causes

It’s not entirely known what causes club foot. It’s thought to be a combination of genetic and environmental factors, like:

• Positioning in the womb: Although rare, the position of your baby’s feet in the womb can contribute to the development of club foot.
• Neuromuscular disorders: Conditions like spina bifida may increase the likelihood of club foot.
• Genetics: a family history of club foot. If one parent has a club foot, there’s about a 1 in 30 chance of your baby having it.

Diagnosis

Club foot is typically diagnosed at birth with a physical examination. Sometimes, it can be detected during a prenatal ultrasound as early as the second trimester.

Club foot in adults

Club foot treatment has improved significantly in the last few decades. Club foot that has not been treated in childhood, or has been treated poorly, can cause adults to experience symptoms in later life like:

• curled toes
• fused ankles
• having to walk on their ankles or the sides of their feet
• callouses
• chronic pain

Adults who were surgically treated for club foot when they were younger may still experience symptoms, too.

Treatment

The Ponseti method is the most effective and widely used treatment for club foot. It involves gently repositioning the baby’s foot and casting it weekly for 5 to 8 weeks. After that, a small surgery (tenotomy) is done to release the tight Achilles tendon.

To prevent the foot from returning to its original position, babies were traditionally prescribed a pair of special boots connected by a bar. These are worn full-time for the first three months, then overnight until the child is 4 to 5 years old.

Although the boots and bar are effective, they can be uncomfortable, and getting a child to wear them can be a challenge. At LOC, we prescribe babies with club foot the Cunningham Brace, which can replace the boots and bar.

Learn more about our club foot treatment.