Brief overview
- Therapy: In newborns padded and regularly adjusted plaster cast, physiotherapy in combination with taping by special adhesive tapes, splints, orthopedic shoes or insoles, in some cases, especially in case of recurrence and acquired clubfoot, surgery
- Symptoms: Visible through inwardly turned soles of the feet and corresponding gait pattern (like walking on the outer edge of the foot), narrower calf
- Diagnosis: Visual diagnosis, imaging techniques (X-ray, ultrasound), foot pressure measurement (pedography).
- Prognosis: Good results with immediate and regular treatment; if left untreated, there is a risk of late consequences such as pain due to stiffened foot, malpositions of the spine or hip, for example.
What is clubfoot?
In most cases, this clinical picture is congenital. If certain muscle groups do not fully form in the child during pregnancy, clubfoot develops. However, baby feet are still very flexible and articulated, which is why good results are achieved with immediate treatment.
There are several deformities of the foot that sometimes occur with clubfoot:
- Sickle foot (called pes adductus or aspirated foot): Read more about this in the article Sickle foot.
- Pointed foot (Pes equinus): Read more about this in the article Pointed Foot.
- Hollow foot (Pes cavus): Read more about this in the article Hollow Foot.
- Pes varus (a bending of the foot inwards in the ankle joint)
What is the treatment of clubfoot?
What to do in case of clubfoot in a baby?
In taping, the first step is daily mobilization of the joints through physiotherapy. Then the affected foot is fixed with the help of special adhesive tapes. The corrections achieved in this way must then be maintained. For this purpose, there are special splints, orthopedic shoes or insoles that must continue to be worn during the growth phase. Regular check-ups are also important.
How do you treat an acquired clubfoot?
In the case of an acquired clubfoot in an adolescent or adult, conservative therapy is very rarely successful. If the cause is nervous, specially made splints or shoes sometimes help. However, the more severe the clubfoot, the sooner surgery must be considered.
What are the symptoms?
In both congenital and acquired clubfoot, the symptoms are clearly visible. The affected person walks on the outer edge of the foot or, in particularly severe cases, even on the back of the foot (as far as this is possible). One foot or even both feet are affected.
Also typical is the so-called narrow “clubfoot calf”, which is caused by atrophied calf muscles and a shortened Achilles tendon.
What are the causes and risk factors?
Possible causes in the baby
- If the unborn child lies twisted in the uterus in such a way that the legs are restricted in growth, this is discussed as a cause.
- A prolonged amniotic fluid deficiency is also a possible cause.
- Early brain damage due to oxygen deprivation may lead to deformities such as clubfoot.
Possible causes of acquired clubfoot
- Neurological diseases in which the muscle supply is impaired.
- A congenital “open back” (neural tube defect) may bring about a defective supply of the lower leg musculature and thus lead to clubfoot.
- Injuries that sever the nerve of the lower leg muscles cause an undersupply of the muscle. As a result, the musculature weakens and clubfoot occurs.
Examinations and diagnosis
A clubfoot can usually be seen with the naked eye. To confirm the visual diagnosis, the physician uses imaging techniques. In doing so, he checks whether the following characteristic features of a clubfoot are present:
- Bony malformations (usually affecting the calcaneus)
- Malalignments or dislocations in the joints (often affecting the ankle joint)
- Weakened or shortened muscles (for example, the calf muscles)
An X-ray examination is suitable as an imaging procedure. The extent of the malformation can be seen more precisely on this.
Recently, ultrasound examination has been used more and more in clubfoot diagnostics. It is a quick and inexpensive method to visualize the supply of a muscle region.
In order to get to the bottom of the causes of clubfoot disease, extensive diagnostics are important in every case, since the cause points the way to treatment.
Course of the disease and prognosis
On the other hand, good results can usually be achieved with immediate and regular treatment.
