What is clubfoot?

Clubfoot (also called talipes equinovarus) is a general term used to describe a range of unusual positions of the foot. Each of the following characteristics may be present, and each may vary from mild to severe:

• The foot (especially the heel) is usually smaller than normal.
• The foot may point downward.
• The front of the foot may be rotated toward the other foot.
• The foot may turn in, and in extreme cases, the bottom of the foot can point up.

Most types of clubfoot are present at birth (congenital clubfoot). Clubfoot can happen in one foot or in both feet. In almost half of affected infants, both feet are involved.

Although clubfoot is painless in a baby, treatment should begin immediately. Clubfoot can cause significant problems as the child grows. But with early treatment most children born with clubfoot are able to lead a normal life.

What causes clubfoot?

In some cases, clubfoot is just the result of the position of the baby while it is developing in the mother's womb (postural clubfoot).

But more often clubfoot is caused by a combination of genetic and environmental factors that is not well understood. If someone in your family has clubfoot, then it is more likely to occur in your infant. If your family has one child with clubfoot, the chances of a second infant having the condition increase.

Clubfoot present at birth can point to further health problems because clubfoot can be linked with other conditions such as spina bifida. For this reason, as soon as clubfoot is noticed, it's important that the infant be screened for other health conditions. Clubfoot can also be the result of problems that affect the nerve, muscle, and bone systems, such as stroke or brain injury.

What are the symptoms of clubfoot?

Clubfoot is painless in a baby, but it can eventually cause discomfort and become a noticeable disability. Left untreated, clubfoot does not straighten itself out. The foot will remain twisted out of shape, and the affected leg may be shorter and smaller than the other. These symptoms become more obvious and more of a problem as the child grows. There are also problems with fitting shoes and participating in normal play. Treatment that begins shortly after birth can help overcome these problems.

How is clubfoot diagnosed?

Ultrasound done while a baby is in the womb can sometimes detect clubfoot. It is more common for your doctor to diagnose the condition after the infant is born, though, based on the appearance and mobility of the feet and legs. In some cases, especially if the clubfoot is due just to the position of the growing baby (postural clubfoot), the foot is flexible and can be moved into a normal or nearly normal position after the baby is born. In other cases, the foot is more rigid or stiff, and the muscles at the back of the calf are very tight.