Club Foot

An Overview

Club foot happens because the Achilles tendon (the large tendon at the back of the ankle) is too short.
Club foot can affect 1 or both feet. It’s not painful for babies, but it can become painful and make it difficult to walk if it’s not treated. Clubfoot can be mild or severe. About half of children with clubfoot have it in both feet. If your child has clubfoot, it will make it harder to walk normally, so doctors generally recommend treating it soon after birth.
Doctors are usually able to treat clubfoot successfully without surgery, though sometimes children need follow-up surgery later on.

About one out of every 1,000 babies is born with a foot that’s twisted. It may curl sideways with the toes bent at a funny angle. Or, it might have an odd shape and point in the wrong direction, so that it appears to be crooked, or even nearly upside down. Doctors call this clubfoot.
Most babies who are born with clubfoot are healthy in all other ways; about half of them have it in both feet.

Symptoms for Club foot

It’s easy to notice clubfoot when a baby is born. Here are some signs:
• The foot points downward, and the toes may be curled inward.
• The foot appears to be sideways or sometimes even upside-down.
• The foot may be smaller than a normal foot by up to a half-inch.
• The calf muscles on the affected leg may not be fully developed.
• The foot may have a limited range of motion.
• The heel on the clubfoot may be smaller than normal.
• In severe cases, the clubfoot may be twisted upside down.
• The calf muscle on the leg with the clubfoot will be slightly smaller.

Causes of club foot

There is also research to suggest clubfoot is more common in babies whose mothers smoked or used recreational drugs (street drugs) during pregnancy. This is especially true if there is already a family history of clubfoot. Plus, there could be a link between low amniotic fluid and clubfoot. Amniotic fluid is the liquid that surrounds a baby in the womb
• In most cases the cause of club foot is not known. There may be a genetic link, as it can run in families.
• If you have a child with a club foot or feet, your chance of having a 2nd child with the condition is about 1 in 35.
• If 1 parent has a club foot, there’s about a 1 in 30 chance of your baby having it.
• If both parents have the condition, this increases to about a 1 in 3 chance.

Diagnosis

Club foot is usually diagnosed after a baby is born, although it may be spotted during the routine ultrasound scan done between 18 and 21 weeks.
Diagnosing club foot during pregnancy means you can talk to doctors and find out what to expect after your baby is born.
Some babies are born with normal feet that are in an unusual position because they have been squashed in the womb.

In most cases, clubfoot is diagnosed after your baby is born. Your doctor will be able to identify clubfoot based on the appearance of your baby’s foot. Sometimes after a visual inspection of the foot, they may also order an X-ray to confirm the diagnosis.
Clubfoot also can be discovered in utero (while the baby is still in the mother’s womb) during an ultrasound. An ultrasound is a type of imaging used to look at babies in the womb. It is routine for a woman to have an ultrasound during her pregnancy to confirm her baby’s growth and development.

Treatment

There are two primary ways to treat clubfoot. One way involves stretching to reshape the foot. The other involves surgery. Most cases of clubfoot can be successfully treated without surgery.
For the majority of babies, stretching and reshaping the foot is the best treatment option. There are a few reliable techniques for treating clubfoot with stretching. The most widely used is called the Ponseti method. Treatment usually begins as soon as possible after birth, typically within the first week. This is the best and easiest time to reshape the foot.
Treatment for club foot usually starts within 1 to 2 weeks of your baby being born.
The main treatment, called the Ponseti method, involves gently manipulating and stretching your baby’s foot into a better position. It’s then put into a cast.
This is repeated every week for about 5 to 8 weeks.
After the last cast comes off, most babies need a minor operation to loosen the Achilles tendon at the back of their ankle.

Complications

Clubfoot typically doesn’t cause any problems until your child starts to stand and walk. If the clubfoot is treated, your child will most likely walk fairly normally. He or she may have some difficulty with:
• Movement. The affected foot may be slightly less flexible.
• Leg length. The affected leg may be slightly shorter, but generally does not cause significant problems with mobility.
• Shoe size. The affected foot may be up to 1 1/2 shoe sizes smaller than the unaffected foot.
• Calf size. The muscles of the calf on the affected side may always be smaller than those on the other side.

Prevention

Because doctors don’t know what causes clubfoot, you can’t completely prevent it. However, if you’re pregnant, you can do things to limit your baby’s risk of birth defects, such as:
• Not smoking or spending time in smoky environments
• Not drinking alcohol
• Avoiding drugs not approved by your doctor

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