About one baby in every 1,000 in the United States is born with clubfoot. Almost half of those babies have bilateral clubfoot where both feet have the deformity. The wonderful news is that there is a non-surgical treatment that, with rare exceptions, can correct clubfoot and help children live normal lives.
Clubfoot is a congenital foot deformity where the foot points downward with toes turned inward and the foot bottom twisted inward. Congenital means the condition exists at birth. The bones, joints and muscles of the foot are abnormal. In addition to the foot, the muscles in the lower leg are not as large as usual and will not develop correctly. Finally, the joints in the ankle do not move as much as normal and restrict mobility.
Most children born with clubfoot have no other congenital problems, but clubfoot can occur with other birth defects.
We're still not sure what causes clubfoot, but there are several theories to explain it:
- The baby's foot stops growing at a certain point before birth.
- There is pressure on the baby's foot in the mother's womb.
- One of the bones in the foot does not form properly, causing the rest of the foot to grow crooked.
- Some of the muscles in the foot do not form normally and cause the bones to grow crooked.
- Heredity.
Prevention of clubfoot is not possible and it is unlikely that anything you did during pregnancy could cause clubfoot. Fortunately, we have an extremely high success rate for correcting clubfoot using the Ponseti method for non-surgical cast correction of clubfoot.
The Ponseti method requires specific training. The Pediatric Foot Clinic at St. Louis Children's Hospital offers patients the opportunity to take advantage of this non-surgical treatment with a certified physician.
Ideally, as soon as possible after birth, the doctor will prepare a cast for your child's foot. The treatment involves weekly stretching of the foot deformity in the clinic, followed by the application of long leg plaster casts. The cast is changed every 1 or 2 weeks, and a newborn with a congenital clubfoot should expect the deformity corrected in about five to six weeks.
Before the application of the final cast, the physician usually performs a tenotomy, an Achilles tendon lengthening using non-invasive surgery. The incision is so small that no stitching is required. Your child wears a final cast for three weeks to allow the tendon to heal. Your child then wears a corrective foot orthosis full time for three months, followed by night and naptime wear for up to four years to prevent the deformity from recurring.
The Ponseti method delivers excellent correction of clubfoot without the associated risks and complications of major foot surgery. Moreover, studies show that patients treated with the Ponseti method enjoy a more flexible foot and ankle than those treated surgically. Long-term studies of the Ponseti method have demonstrated that cast correction of clubfoot not only helps dramatically during childhood, but also in adulthood.
The Pediatric Foot Clinic at St. Louis Children's Hospital practices two enhancements to the Ponseti method. First, the clinic instructs parents in the science of stretching and exercising their child's feet to improve the mobility of the ankle. A second variation is the type of brace offered. An Ankle Foot Orthosis (AFO) is custom molded from a mold of the child for a perfect fit. An articulating abduction bar is used to allow independent leg movement. This brace has a higher rate of patient compliance than the traditional clubfoot orthosis.
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"The Clubfoot Center at St. Louis Children's Hospital/Washington University School of Medicine" Video |
Get more information on the Dobbs Dynamic Clubfoot Bar.
For more information about the Ponseti method and the non-surgical correction of clubfoot at St. Louis Children's Hospital, contact one of our nurses at the Pediatric Foot Clinic to set up an initial appointment. You can get more information by calling 314.454.4192 or 314.454.2065.