Clubfoot, otherwise known as Congenital Talipes Equino Varus (CTEV), is a common condition that affects one or both feet of a newborn baby. A baby with clubfoot has a foot that turns down and in at the ankle.

What Causes Clubfoot?

In many cases, we don’t really know what causes the problem; this is called idiopathic clubfoot.

Sometimes there can be an association

• Positional clubfoot – Due to cramped up space in the mother’s womb during pregnancy, the baby may develop positional clubfoot. This is temporary and is not true clubfoot. After stretching and rotating the foot, it returns to its normal shape.
• Genetics - Clubfoot MAY “run in the family” but is not associated in all cases.
• Environmental causes – Smoking and alcohol intake during pregnancy has increased incidences of clubfeet in children.
• Neuromuscular disorders or syndromes – Sometimes clubfoot is seen associated with other problems like myelomeningocele, arthrogryposis, spina bifida and other conditions.

Antenatal diagnosis of Clubfoot

In some cases, clubfoot is first found on prenatal ultrasound and prenatal counselling by a paediatric orthopaedic is very useful. However, in India, most cases are noticed at birth.

Treatment

A technique called the Ponseti method accepted worldwide is the standard treatment for clubfoot. Your child will have their foot/feet gently stretched, and a series of casts applied to correct the foot. If needed, this is followed by a small surgical procedure to lengthen the Achilles tendon.

A foot brace, also known as the Steenbeek splint is then used to overcorrect the feet and hold them in a corrected position.

Clubfoot has a tendency to return to its original position (relapse) even after correction. To prevent a relapse, your child’s foot/feet must stay in the overcorrected position for the correct length of time. This duration will be explained to you by the doctor.

Key points to remember

• Clubfoot is a common condition in newborn babies (1 in 1000 live births).
• Treatment is very effective in correcting and preventing a relapse.
• Your child will wear the brace until they are four years old.