Clubfoot

Diagnosis

Many times, a healthcare professional diagnoses clubfoot soon after birth just by looking at the shape and position of the newborn’s foot. Sometimes X-rays are taken to understand how severe the clubfoot is, but usually, they are not needed.

Often, clubfoot can be seen before birth during a routine ultrasound exam around the 20th week of pregnancy. While the condition cannot be treated before birth, knowing about it early allows parents time to learn more about clubfoot and plan for treatment. It also provides an opportunity to consult with health experts such as a pediatric orthopedic surgeon. If needed, a medical genetics counselor can explain genetic test results and discuss the risk of having a baby with clubfoot in future pregnancies.

More Information

• Ultrasound

• X-ray

Treatment

Because a newborn’s bones, joints, and tendons are very flexible, treatment for clubfoot usually begins within the first one to two weeks after birth. The goal of treatment is to move the child’s foot into the correct position so the sole faces downward. Early treatment gives the best long-term results.

Treatment options include:

• Stretching and casting (Ponseti method)

• Stretching, splinting, and taping (French method)

• Surgery

Casting: Ponseti Method

Casting is the main and most common treatment for clubfoot. The healthcare professional:

• Moves the baby’s foot into a better position and places it in a cast to hold it there

• Repositions and replaces the cast once a week for several months

• Performs a minor procedure to lengthen the Achilles tendon near the end of the process

Once the foot’s shape improves, it must be maintained in the correct position. This is done by using special shoes and braces.

Parents are advised to:

• Ensure the child wears the shoes and braces as directed, usually all day and night for 3–6 months, and then only during naps and nighttime until age 3–4 years

• Contact the healthcare professional immediately if the braces do not fit or the child outgrows them

If the braces are not worn properly, the foot may return to its original turned position. Even with treatment, some children may have partial recurrence of the condition. If the foot begins turning inward again before age two, more casting may be required. Most babies treated early can later wear regular shoes, play sports, and lead active lives.

Stretching, Splinting and Taping: French Method

The French method, developed in France, is mainly used for mild cases of clubfoot. It involves:

• Daily stretching of the foot into a better position

• Taping and splinting to hold the correction

• Frequent physical therapy sessions and daily exercises performed by parents until the child is 2–3 years old

• A minor procedure to lengthen the Achilles tendon

Surgery

Surgery may be needed if casting does not correct the clubfoot or if the condition reappears later. Even with early treatment, some children may need surgery between 3–5 years of age if the foot continues to turn inward.

During surgery, the orthopedic surgeon repositions tendons to help maintain proper alignment of the foot. This procedure, called a tibialis anterior tendon transfer, generally produces excellent results.

In rare and severe cases, or when clubfoot is associated with other syndromes, more extensive surgery—called a posterior release or posteromedial release—may be necessary. This surgery loosens tight ligaments in the back and side of the ankle to achieve a larger correction. However, the foot may become stiff, and there is a higher risk of pain later in life.

After surgery:

• The child wears a cast for up to two months

• A brace is worn for several years to prevent recurrence

Request an Appointment

If your baby is diagnosed with clubfoot, you will likely be referred to a pediatric orthopedic surgeon.

Preparing for Your Appointment

Before meeting your child’s healthcare professional, prepare a list of questions such as:

• Do you commonly treat newborns with clubfoot?

• Should my child be referred to a specialist?

• What treatment options are available?

• Will my child need surgery?

• What follow-up care is required?

• Should I get a second opinion, and will my insurance cover it?

• After treatment, will my child be able to walk normally?

• Are there resources or websites to learn more about clubfoot?

You should also share whether you:

• Have family members with clubfoot

• Experienced any complications during pregnancy

Being well-prepared helps ensure meaningful discussions and better planning for your child’s care.