Description

This condition is also known as Talipes Equinovarus and is a congenital condition. A congenital condition is one that happens at birth. Sometimes the foot is simply turned abnormally during pregnancy, this is not a “true” Club Foot. Club Foot can affect one, or both feet. With some children the bones of the feet may be abnormal in shape, size and/or position. The foot is turned inward and downward.

 

Symptoms

Clubfoot requires the attention of a physician and the clubfoot deformity will require correction with a series of casts, possible surgery and manipulation to the affected joints. Without the casting, many other symptoms may develop. Once the child begins walking on the uncorrected foot there will be increased pressure placed toward the lateral (outside) border of the foot. Since the outside of the foot is not conditioned to be walked on, the skin can break down, leading to infection. The abnormal gait could cause joint wear and also chronic arthritic symptoms.

After a series of casting, which must be changed throughout the rapid growth stages, further bracing may be required. These braces are normally worn at night until about the age of two.

The true cause of Club Foot is unknown. This condition affects approximately 1 in every 1,000 newborns each year, with more males than females. There are possible links to smoking during pregnancy. In very rare instances Club Foot can be associated with deformities such as spina bifida or other neuromuscular diseases, in which the foot is more greatly deformed.

 

Pedorthic Management

  • Custom made orthotics – rigid or semi-rigid
  • Orthopedic Footwear – properly fitted – deep, wide, well structured footwear with appropriate modifications – rocker soles with lateral flares to aid in propulsion in gait.
  • Dennis-Browne Bar or Night Splint – combination of shoes and bar encourages outward rotation of feet

 

Other Treatments/Modalities

  • Bracing – to be worn as corrective or preventative (maintenance) measure post surgery
  • AFO – Ankle Foot Orthosis: fully covers both foot and ankle providing structural support
  • Surgery – an Achilles Tendon release, to allow the foot to assume a more natural position. The short side of the tendon will be lengthened, and the long side shortened. Older children and adults are less flexible than babies and may require more extensive repair. The surgeon may need to cut into the bone to turn the foot. In these cases, metal plates or screws are used to hold the foot in the correct position.