Club Foot

Club Foot affects single or both feet (40% bilateral) and occurs in almost 100,000 live births annually; more in boys than girls; and sometimes run in families (in families with one child born with clubfoot, the chance of a second child being born with the deformity is 1 in 35). Club foot is either Idiopathic (the most common) and occurs mostly in isolation, or Non-Idiopathic and occurs in association with other problems such as spinal cord deformities, spina bifida, poliomyelitis, and other conditions. Newborns with Club foot should be investigated by specialized orthopedic surgeon soon after birth to differentiate club foot from normal positional foot deformity that corrects spontaneously without treatment. Treatment for clubfoot is recommended at a very young age, often within a week or two of birth. Progressive casting, known as the Ponseti Method, often results in complete correction with low rates of recurrence. Individuals with untreated or poorly-treated clubfoot often suffer severely limited mobility and pain, resulting in social, psychological, and financial consequences for not only the patient, but their family as well. At our center, we treat clubfoot using the Ponseti Method at our Clubfoot Clinic. The Ponseti Method: The Ponseti Method of clubfoot correction consists of alternative sessions of manipulation and casting to correct all the components of the foot deformity in consequence and successfully. Correction occurs by abducting the foot (toward the outside of the body) in supination (foot rolled outward) while applying counter pressure over the side of the head of the talus (ankle bone) to prevent rotation of the talus in the ankle. Last component to be corrected is the ankle equinus (limited ability to pull the foot upwards). Manipulation is performed for approximately five minutes followed by application of a well-molded, long-leg plaster cast for five to seven days every session. Most cases of clubfoot are reduced in 4 to 7 casts based on its severity. Approximately 80 percent of clubfoot infants require an Achilles tendon tenotomy to correct the ankle equinus and complete correction.