Talipes equinovarus (TEV) is the medical term for clubfoot, and our pediatric orthopedic physicians are specialists in this common, treatable condition.
In most cases of clubfoot, the foot appears twisted inward at the ankle. While clubfoot may be detected during pregnancy, it is visibly obvious at birth. Occurring twice as often in boys than girls, it may affect both feet (bilateral clubfoot) or just one foot.
Clubfoot tends to run in families. Though the causes of club feet are unknown (idiopathic), it is not believed to be "caused" by any actions during pregnancy. While many times not related, clubfoot can have a link to disorders or syndromes, such as developmental hip dysplasia, spina bifida or arthrogryposis.
Clubfoot is treatable, and most patients enjoy fully-functioning use of the once-affected foot.
Specific treatments and services may vary by location. Please contact a specific location for more information.
The likelihood of your child having clubfoot rises with previous cases in the family:
- For parents with no family medical history of clubfoot, and no other children with clubfoot, the chance of having a child with clubfoot is 1 in 1,000.
- If a child is born with clubfoot, then future siblings have a 3% (3 in 100) chance of having the same condition.
- Parents who had clubfoot have a 20-30% chance of having a child with clubfoot.
Treatment Options for Clubfoot
The Ponseti method has been around for about 50 years. It was named after Dr. Ignacio Ponseti. This treatment is started soon after your baby is born. During this time, the ligaments, joints and tendons are the most flexible. The Ponseti method includes gentle massage and moving parts of the foot to stretch the tight or shortened segments of the clubfoot slowly into a good position. The foot is then held in place with a long leg cast for about a week at a time. During this time, the muscles and ligaments stretch enough to allow a little more correction in the foot’s position. The cast is taken off and the foot is again massaged or stretched and moved into a better position. A cast is put on again and after about six to eight weeks, equaling six to eight casts, the foot is in a good position.
To help get the foot in the best position, most babies with clubfoot will need to have their Achilles tendon lengthened. This is called a tenotomy. The Achilles tendon is a strong tendon that goes from the calf muscles to the heel. This tendon can be so tight that the foot will not go into the right position, but a tenotomy can fix this. This procedure allows the foot to go into the very best position. A cast is then put on for the next three weeks until the tendon fully heals. This last cast is taken off in the clinic and a special splint (brace) is used to keep the foot from moving back into the wrong position.
This special brace is made of two high-top, open-toed shoes that are fixed on a metal bar. The brace must be worn full time (23 out of 24 hours a day) for the first three months. After this time, your child will be checked into the clinic. If the foot is doing well, your child will be able to wear the brace only at night and during naps. Wearing the brace exactly as instructed is important. If the brace is not used the right way each day, the foot may not stay corrected. Children with club feet will need to wear the brace until around the age of 4.
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