Clubfoot

Diagnosis

Clubfoot can be determined during pregnancy starting at 20 weeks of pregnancy through ultrasound. It can also be observed instantly by the doctor during birth. Further investigation can be done by performing X-ray to the baby’s clubfoot to measure the severity of the condition.

Treatment

Treatment can start in the first 2 weeks after birth because a newborn baby has a very flexible joints, tendons and bones. The following treatments can be done:

• Manipulation and casting (Ponseti method). Most common treatment for clubfoot. Gentle stretching and manipulation of the affected foot followed by a long-leg cast to hold the foot in place. The process of stretching, re-positioning, and casting is repeated weekly until the foot is improved. Mostly the treatment takes about 6 to 8 weeks.
• Percutaneous Achilles tenotomy. A minor surgery usually done after manipulation and casting process, which can be performed to release the tightness in the Achilles tendon. After the procedure, a new cast will be applied to the leg for  3 weeks. The tendon will regrown to a proper, longer length.

It is better for the child to undergo treatment in order to improve the physical appearance of the foot, ability to walk and avoid any other disabilities in the future.

When the clubfoot of the child has been realigned, the following techniques shall be followed:

• Stretching exercises
• Special braces or shoes for the baby (also known as boots and bar). Should be recommended and supervised by the doctor, and worn constantly for as long as three months. After that, it can be worn while sleeping for up to three years. This method can fail if not done properly.
• French method (also called functional or physical therapy method). A non-surgical method combining Stretching, mobilization and taping done under the supervision of a physical therapist.

Surgery

A more invasive surgery may be needed if the condition persist even after the above treatments mentioned. The foot will be aligned and lengthened by the orthopedic surgeon. The baby will be in a cast for up to two months post-surgery. Then, braces should be worn to avoid the recurrence of clubfoot. Keep in mind that clubfoot may not be fully corrected but children who were treated early can live a full and active life.