Clubfoot – Symptoms and Causes

Overview

Clubfoot is a birth condition where a baby’s foot points inward and downward due to shortened tendons. This common condition affects up to 1 in 1,000 newborns and is also known as congenital talipes equinovarus.

About half of children with clubfoot have it in both feet.

The severity of clubfoot varies from mild to severe. Without treatment, a child may develop an abnormal walking pattern, walking on the side or top of the foot. This can lead to:

• Noticeable limping
• Painful skin sores
• Callus formation
• Difficulty wearing regular shoes

Important facts about clubfoot:

• It won’t improve on its own
• Most babies with clubfoot don’t have other medical problems
• Treatment is most effective when started within weeks of birth

The main treatment approach involves a specific casting technique, often followed by a minor procedure to lengthen the heel tendon. When treatment begins early, the outcomes are typically positive.

Signs of Clubfoot

Clubfoot has several common signs that parents may notice.

The top of the foot typically points inward and downward, which makes the arch appear higher and turns the heel inward. In severe cases, the foot might look almost upside down.

The affected foot or big toe might be slightly shorter than the one on the other side. Children with clubfoot usually have smaller calf muscles in the affected leg.

It’s important to know that newborns with clubfoot don’t feel pain or discomfort from this condition.

When You Should Contact a Medical Professional

A healthcare provider will typically identify clubfoot during your baby’s first examination after birth. If this condition is found, you may receive a referral to a pediatric orthopedic surgeon.

These doctors specialize in treating bone and muscle conditions in children.

Causes

Clubfoot doesn’t have a clear single cause. Medical experts believe both genetic factors and environmental elements play important roles in its development.

Family history might increase a child’s risk, suggesting hereditary links. Some environmental factors during pregnancy may also contribute to this condition.

Risk Factors

Clubfoot occurs more frequently in boys, with males being about twice as likely as females to develop this condition.

Several factors may increase a child’s risk of clubfoot:

• Genetic Factors: Children with a parent or sibling who has clubfoot face a higher likelihood of developing the condition.
• Associated Conditions: Clubfoot sometimes appears alongside other birth conditions like spina bifida, where the spine doesn’t form properly, or certain chromosomal abnormalities.
• Maternal Smoking: When a mother smokes during pregnancy, it can increase the baby’s chance of developing clubfoot.
• Low Amniotic Fluid – Insufficient amniotic fluid (the liquid surrounding the baby in the womb) during pregnancy may raise clubfoot risk.

Possible Problems

Children with clubfoot may face several issues even after treatment.

The foot might remain somewhat stiff and not bend as easily as a normal foot. There could also be a slight difference in leg length, though this typically doesn’t prevent walking.

Other differences include shoe size variations, with the affected foot being up to 1½ sizes smaller than the other foot. The calf muscles on the affected side may also remain smaller.

Additionally, the treated foot might retain a slightly bean-shaped appearance with a small inward point.

Without proper treatment, more serious complications can develop:

• Walking Difficulties: Untreated clubfoot forces children to walk on the side or top of the foot, causing:
  • Painful sores and calluses
  • Trouble finding suitable shoes
  • Noticeable limping
• Treatment Timing Challenges: Delayed treatment often requires more extensive intervention, including additional casting and possibly surgery. Early treatment before bone reshaping produces better results.

• Joint Problems: Some children may develop swelling and tenderness in the joints, similar to arthritis.

• Self-Esteem Issues: The appearance of the foot can affect body image and confidence, particularly during teenage years when physical appearance becomes more important.

Preventing Clubfoot

While doctors don’t fully understand what causes clubfoot, pregnant women can take steps to promote healthy fetal development and reduce risks.

These preventive measures include:

• Avoiding tobacco smoke completely, including secondhand exposure
• Not consuming alcoholic beverages during pregnancy
• Staying away from recreational drugs and street substances
• Only take medications approved by your healthcare provider