What is Club Foot?

Clubfoot is a congenital foot deformity observed in infants and can be characterised by the inward twisting of the heel and toes. In some cases, clubfoot can be so severe that the sole is found facing sideways or even upwards. Approximately 1 in 1,000 children are born with clubfoot, and half of these cases involve both feet.

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Clubfoot can be diagnosed during a prenatal ultrasound around the 20th week of pregnancy or immediately after birth. As early intervention yields the best results, expectant parents often seek consultations before the baby is born to discuss corrective plans for clubfoot. Since the bones and joints of newborns are very flexible, interventions can start within the first week of life.

Risk Factors for Clubfoot

While the definitive causes for clubfoot remain unclear, there are several factors that can contribute to a child being born with this condition, including:

  • Male gender
  • Family history of clubfoot
  • Smoking during pregnancy
  • Congenital deformities associated with spinal defects like spina bifida
  • Other birth defects

In most infants, clubfoot itself may not be painful initially but without intervention, the condition. may escalate and impede mobility. This can significantly impact the child in adulthood, leading to abnormal walking patterns and an increased risk of arthiritis.

Patients may eventually develop calluses due to their abnormal gait, which can progress to skin breakdown, ulceration, and possibly infection. In severe, unaddressed cases, amputation may become necessary.

How Is Clubfoot Managed with Podiatry?

Clubfoot management focuses on restoring full function, reducing pain, and addressing visual deformities. Traditional surgical approaches have given way to conservative or minimally invasive podiatric care, with various techniques, including:

  • Examination, evaluation, and advice
  • Progressive serial rigid casting sessions
  • Soft casting and splints
  • Long-term orthotics, ankle-foot orthotics, or braces to prevent recurrence
  • Specific footwear

The Ponseti method

The Ponseti method is a highly specialised approach involving gradual stretching and casting of the leg(s). This process is repeated weekly for 6 – 8 weeks until a fully corrected position is achieved. After the casting is removed, your podiatrist may recommend ankle foot orthotics (AFOs), bracing, and prescription insoles to maintain the corrected alignment and to prevent relapses.

Parents are urged to consult a podiatrist to determine their child's specific needs for a customised plan. Early intervention and proper care can effectively manage clubfoot. If podiatric care proves unresponsive, surgery by an orthopedic surgeon may be necessary to adjust tendons and ligaments for improved realignment.

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Common Symptoms

The top of the foot is twisted downwards and inwards
If only one foot is affected, it may be up to 1cm shorter than the other limb

How It Looks Like

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Related Conditions


Does My Child Have Clubfoot?

If your child’s foot is displaying a “down and in” structure or you notice a deep crease in their foot, your child may have clubfoot. Seek a consultation with a podiatrist for a prompt diagnosis.

How Early Is Clubfoot Diagnosed?

Clubfoot can be highlighted during inter-uterine scanning, especially during a routine ultrasound around week 20 of the pregnancy. A consultation with a podiatrist can be helpful for discussing possible strategies before the baby is born.

When Can I Start Addressing Clubfoot?

Podiatric intervention can and should be done as early as one to two weeks after birth. It is essential that the diagnosis is made in time and proper care is given as soon as possible.

What Happens If Clubfoot Is Left Unaddressed?

If clubfoot is left unaddressed, a permanent rigid clubfoot deformity will remain as the child grows into adulthood, causing disability and leading to exclusion from activities among their peers. Asymmetrical walking will lead to imbalanced biomechanics and unequal pressure points in the feet. These may eventually cause the formation of calluses and ulcers, which could lead to bone infection over time and may result in amputation. Your child must seek comprehensive care as soon as possible to prevent the start of these cascading events.

What Should I Do If My Child Is Considered Too Old For Casting?

The age limit for casting is unclear but the ideal period for casting should start in the first few weeks after birth when the baby’s connective tissues are at their most malleable. In cases of delayed intervention and depending on the severity of your child’s clubfoot, long-term orthotics or ankle braces may be sufficient enough to assist with the correction of their feet. Our podiatrists specialise in designing small, intricate, corrective devices for such cases. However, if the neglected clubfoot deformity has become too severe to manage conservatively, surgical intervention will be required once the patient has reached skeletal maturity.

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Very positive experience for both adults and children’s podiatry needs

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Our Podiatry Care Strategy

100% non-invasive methods

A lower limb specialist, such as a podiatrist, will be able to perform a thorough foot assessment using diagnostic tools, such as a musculoskeletal diagnostic ultrasound to determine the source of your foot pain. If surgery is required, your podiatrist will refer you to a trusted foot and ankle doctor for surgical solutions.

A thorough assessment

Immobilising the area with splints

Utilising technological therapies

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