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What is clubfoot?
Clubfoot, also called talipes equinovarus, is a birth defect that affects the foot and ankle. It’s a congenital condition, which means that a baby is born with it. The foot or feet turn inward. When you look at the foot, the bottom of the foot often faces sideways or even up.

Clubfoot happens because of a problem with the tendons, the tissues that connect muscle to bone. The tendons in the baby’s leg and foot are shorter and tighter than they should be. That causes the foot to twist.

Extensive surgery used to be the main treatment to correct clubfoot. But today healthcare providers typically use a combination of nonsurgical methods and a minor procedure.

What are the types of clubfoot?
There are two types of clubfoot:

Isolated or idiopathic clubfoot is the most common type. If your child has clubfoot with no other medical problems, it’s called isolated clubfoot. Idiopathic means that the cause of clubfoot is not known.
Nonisolated clubfoot happens along with other health problems. These conditions include arthrogryposis (a joint problem) and spina bifida (a neural tube disorder). Neural tube defects are problems of the brain, spine and spinal cord.
Who is at risk for congenital clubfoot?
Boys are up to twice as likely to develop clubfoot as girls are. Having a family history of clubfoot also puts the baby at higher risk.

Babies are also at higher risk if they have:
Another birth defect, such as spina bifida or cerebral palsy.
A genetic condition, such as Trisomy 18 (Edward syndrome).
A woman may be at higher risk for having a baby with clubfoot if she:

Had oligohydramnios during pregnancy. This is a problem of not having enough amniotic fluid, the fluid that surrounds the baby.
Had Zika infection during pregnancy, which can lead to birth defects and other problems.
Smoked, drank alcohol or used illegal drugs during pregnancy.
Does congenital clubfoot affect one or both feet?
About half of babies with clubfoot have a problem with both feet.

How does clubfoot affect my baby?
Clubfoot isn’t painful for your baby. Many babies won’t even notice it during the first few months of life. But clubfoot will get in the way of standing and walking. It won’t go away on its own. Babies with clubfoot need treatment to correct the problem before they reach walking age.

Untreated clubfoot can lead to:
Walking problems. Babies with clubfoot often walk in unusual ways. Typically, people walk on the bottoms and soles of their feet. A baby with clubfoot may walk on the sides and tops of the feet.
Foot infections.
Foot problems, including calluses. A callus is a thick layer of skin that often develops on the sole of the foot.
Arthritis, a joint condition that causes pain, stiffness and swelling.
How common is clubfoot?
Clubfoot is one of the more common problems children are born with. Around 1 in every 1,000 babies is born with clubfoot.

SYMPTOMS AND CAUSES
What causes congenital clubfoot?
Researchers don’t know the exact cause of clubfoot. It’s most likely a combination of genetics and environment:

Genetics: Genes tell the body how to look, grow and function. A problem with one or more genes (which are passed down from parents to children) could result in clubfoot.
Environment: Drug use and smoking during pregnancy may raise the risk of having a baby with a birth defect such as clubfoot.
What are the symptoms of clubfoot?
The most common sign of clubfoot is one or both feet turning inward. The foot faces the opposite leg.

You may also notice that the foot has a:
Kidney shape.
Deep crease on the inside mid aspect of the foot.
Higher arch than normal (called cavus foot deformity).
Other problems you may notice:

A smaller calf muscle in the affected leg.
Shorter foot.
Ankle stiffness.
Lack of full range of motion in the foot.

DIAGNOSIS AND TESTS -
When and how is clubfoot diagnosed?
Many times, a healthcare provider notices clubfoot when you’re having an ultrasound during pregnancy. A prenatal ultrasound shows pictures of your baby in the uterus (womb). If your provider diagnoses clubfoot during pregnancy, you can start planning for the treatment your child will need after birth.

Other times, your provider may diagnose clubfoot after the baby is born. They’ll usually notice it during one of the baby’s first physical exams. In some cases, your provider may recommend an X-ray to confirm the diagnosis.

MANAGEMENT AND TREATMENT
When should clubfoot treatment start?
Healthcare providers recommend treating clubfoot as soon as possible. Early treatment helps the child avoid problems later. It’s best to begin treatment during the baby’s first two weeks of life.

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