Managing Club Foot In Infants
Health Education

Managing Club Foot In Infants

Dr.Surya Rao Poodipeddi profile Authored by Dr.Surya Rao Poodipeddi on 28 Aug 2014 - 16:16.

Club foot also known as Talipes, is a condition in which a baby is born with one or both feet twisted out of shape or position. Present at birth, this condition sometimes runs in families. Babies are often born with their feet in some awkward positions none of which interfere with their walking or lifestyle unless the defect is severe when we term it as club foot.

The affected foot tends to be smaller than what it should be, with the heel pointing downward and the forefoot turning inward. The tendon meant to move the ankle joint called the Tendo Achilles remains tight causing the heel to be drawn up towards front of the leg giving it the classical picture of a condition termed as "equines". When this happens, it is just impossible to land the foot flat on the ground. This condition usually starts when the baby is three months old in the mother’s womb and hence the deformity remains rigid.

There are two types of club foot.

  • Positional Club foot: In this type the twisted foot is flexible, and thesize of the foot is normal except that it gets twisted. This can be due to compression in the uterus while the fetus is still in the womb. In most cases the deformity is mild and gets corrected by itself. The deformity can be manipulated into a normal position with a plaster cast for a prolonged period to keep the correction undisturbed. Once the plaster is removed, the normal position is restored. The procedure is done under general anesthesia since it requires considerable manipulations to restore  normalcy.
  • Structural Club foot: In this type the deformity in the foot is very rigid and manual correction becomes difficult. After manual correction the child needs to be in a plaster cast for more timethan in the other type. If the attempts are not successful one may need surgical correction when the child is 6 to 9 months old. Surgery generally helps and the child can walk normally. This type which affects one in every 700 births is more serious than the other type.

It is important to note that celebrity sports persons born with a club foot have made records in their respective fields of sports.

No one really is aware of what causes this defect. We therefore term the cause as idiopathic (unknown). It is an isolated congenital birth defect. Some believe that the condition results from abnormal development of the muscles, tendons and bones during the formation of the fetus in the mother’s womb. Though researchers are still not clear in pinpointing the cause, they believe that both genetic and environmental conditions play a role.

Modern science has facilities to detect the presence of club foot perinatally even when the fetus is only 16 weeks inside the womb. This will facilitate an early appointment with a pediatric orthopedician and chart out a line of action before it becomes late. Any delay or negligence will only make the deformity worse in later life making it rather difficult for even for surgical corrections. Club foot is usually detected during a routine examination of a child soon after birth.

Statistics reveal that Club foot is twice as common in males and occurs bilaterally (both feet). In more than 50 percent of cases it occurs in both feet. If both parents are normal and have a child with club foot, it is  possible the next child might end up with the same problem though the percentage of such a possibility is only 2 to 5. In certain Neurogenic conditions like spina bifida, it is possible the child may also have a club foot.

Depending on what type of club foot the child is found to have, there may not be a need for any treatment since some cases are mild and self-limiting, some may need correction through manipulation and plastering and still some babies may need a surgical correction. Unless the deformity is so awkward and rigid there is no cause for any anxiety on the part of the mothers with such babies. However, they should remember that whatever be the type of club foot the child has, it must be diagnosed early and treatment must start at once unless surgery is needed when they can wait till the child is at least 9 months.

One of the treatment options is the French method, which is easiest to do with young bones. The patient's foot is gradually stretched to achieve the correct position, being held in place with tape after stretching. The child’s foot is hooked up to a machine in the evening, where the foot is continuously moved while the child is asleep.

*Disclaimer This is not medical advice. The content is for educational purposes only. Please contact your doctor for any health care issues.