Most people have probably heard of the condition congenital talipes equinovarus — more commonly known as “club foot.”
The condition is thought to be genetic and affects around 1 in 1000 of all children born in the United States.
Club foot has a long history, in fact, the first doctor to offer a suggestion as to what causes it was the famous Greek doctor Hippocrates well over 2000 years ago.
While our understanding of the condition is still a bit hazy, it is able to be treated if caught early enough.
We have compiled this guide to help those parents whose children are suffering from club foot.
We hope to broaden your understanding of the condition, as well as possible treatment options that are available to you.
What Is Club Foot?
Club foot is a condition wherein the foot turns inwards. When a baby has club foot, their feet will look like someone is twisting the feet inwards. In very severe cases the twisting of the foot can get so bad that feet will appear as if they are upside down. But, affects more than just the feet. A baby with clubfoot will also have extremely underdeveloped muscles in their calves. Contrary to what you might expect, babies with clubfoot do not actually suffer any pain because of the condition.
What are the Causes of Club Foot?
The exact causes of club foot are still a matter of debate. While genetics play a strong role, scientists are still unsure about other factors and exactly how big a role genetics actually play compared to these other factors. To give an example, one study has shown that in Caucasian populations, around 30% of people who have a child with club foot report that their family has a history of club foot. However, in Polynesian populations, 54% of people who have children with club foot report that it runs in their family. Other factors also confuse scientists. For example, club foot is far more common in male babies than it is in female babies (around 2 male babies develop the condition for every 1 female baby).
Other studies have looked at other potential causes of club foot. For example, one study looked at whether smoking while pregnant could lead to club foot. The study found that smoking while pregnant increases the chance of a baby developing club foot by around 1% (which is basically negligible). However, what the study also found that was extremely interesting was that smoking while pregnant drastically increased the chances of the baby developing club foot if there is also a family history of club foot.
Another factor that can lead to the development is the presence of other conditions. For example, a child who has a condition like spina bifida or other neuromuscular conditions is at a greater risk of developing club foot.
Finally, there is also a condition called postural club foot. Now, the name may suggest that it is a form of club foot that is similar to the condition we have been describing above. It is mostly the same, except in two key areas. First off, postural club foot is not genetic but is simply the result of a baby being awkwardly positioned in the womb. So, whereas we do not quite know the exact causes of regular club foot, we know the exact causes of postural club foot. Secondly, postural club foot is much easier to treat than regular club foot.
Club Foot Treatment Options
Thankfully, a doctor should be able to immediately diagnose that a baby has club foot the moment the baby is born. If not, then they should be able to quickly diagnose the issue very shortly after birth. Catching the condition early is crucial. If it is not caught quickly, then it becomes more difficult to treat. There are 3 main treatment options, all with their own success rates.
1. Ponseti Technique
For Americans and much of the rest of the world, this will be the first method doctors try. The feet are manipulated and then placed into a cast (this is referred to as a Ponseti cast). Around 5 casts will be worn until the child is approximately 4 years old. At which point the possibility of the club foot reappearing goes down. With this method, the child’s Achilles tendon will need to be regularly clipped in order to ensure that the foot realigns itself properly. This technique has gained popularity due to its huge effectiveness. Studies consistently show that the effectiveness of this technique is around 90%.
2. French Method
In this method, the child’s feet are regularly massaged by a physician for half an hour. Afterward, the child’s foot is held in place using tape to prevent the feet from going back into their original position. Very often a physician will also supplement their own massaging with the use of a CPM (continuous passive motion) machine. Children will use the machine for around 7 hours a day and it will help keep their feet from going back into their original position.
As the name suggests, this method is primarily used in France. The reason being is that some English studies have suggested that this method is not that effective. One study, in particular, asserted that this method has only a 68% success rate, which puts it far below the 90% success rate of the Ponseti technique. Other studies have attempted to refute this, but in the end, the French method is just not that popular outside of France, so it is very unlikely that an American doctor will recommend this method.
3. Surgical Method
Finally, a doctor may choose to go straight to surgery. There are many different surgical techniques a doctor can use to help correct club foot. In many cases, the doctor will simply move the tendons in the foot around to help keep the foot in place. After surgery, a child will have to wear a brace or splints for at least a year to help prevent the club foot from coming back. The success rate of surgery depends heavily on when the surgery is done. Postponing the surgery can cause the success rate to drop massively, to the point where the success rate is as low as 35%.
The odds of a child being born with club foot are very low, and in most cases, it is discovered immediately by doctors. The high success rates of the Ponseti Technique should provide some peace of mind that your babies foot will be back to normal quickly.