Clubfoot is a congenital condition in which the foot is abnormally formed and twisted toward the toe. The type of treatment necessary depends on the specifics and the severity of the deformity.
Clubfoot (also called Talipes Equinovarus) is a congenital * condition in which the foot is abnormally formed and rigidly twisted toward the toe. Clubfoot occurs when the bones, muscles, tendons, and blood vessels develop abnormally during the first 8 to 12 weeks of fetal development.
About 1 in 1,000 babies in the United States is born with clubfoot. This number varies worldwide and by ethnicity. A baby is more likely to be born with clubfoot if a parent or a sibling also has this defect. Boys are two times more likely than girls to be born with this defect, and about half of all children with the condition are born with both feet affected.
The clubfoot has a characteristic appearance. The foot is often smaller than normal, and the front of the foot is twisted and drawn stifHy toward the big toe. The heel cord (Achilles tendon) may be abnormally short and tight, pulling the foot backwards towards the heel. Some people describe its appearance as “kidney-shaped.” The sole of the foot is also twisted into a more upward position than normal; if walking were to occur, weight would be born by the side of the foot, rather than the sole. Because this deformity occurs very early in fetal development (within the first trimester of pregnancy), at birth the foot is held very rigidly in this position.
Untreated, clubfoot can result in significant disability, since walking is difficult and abnormal. Without treatment, the child is forced to walk on the outside of the foot, rather than flat on the foot's sole. Other bony changes occur over time in the untreated clubfoot, which can be further disabling.
The diagnosis of clubfoot at birth is quite simple given the characteristic appearance of the foot. Additionally, because clubfoot occurs so early in fetal development, clubfoot can sometimes be identified during a routine 16-week prenatal ultrasound * .
With treatment, children with clubfeet can go on to grow, develop, and function quite normally. Well-known athletes who were born with clubfeet include Olympic gold medalist skater Kristi Yamaguchi, Olympic gold medalist soccer player Mia Hamm, and former San Francisco Giant Freddy Sanchez.
Clubfoot cannot be prevented, but genetic counseling can help affected individuals understand the risk of passing the condition on to their offspring. Additionally, the general risk of birth defects is decreased in women who do not smoke, drink alcohol, use drugs or medications, or experience other potentially toxic exposures during pregnancy.
See also Birth Defects: Overview
Rinzler, Carol Ann. Leonardo's Foot: How 10 Toes, 52 Bones, and 66 Muscles Shaped the Human World. New York: Bellevue Literary Press, 2013.
MedlinePlus. “Clubfoot.” U.S. National Library of Medicine. http://www.nlm.nih.gov/medlineplus/ency/article/001228.htm (accessed November 28, 2015).
American Academy of Orthopaedic Surgeons. 6300 N. River Rd., Rosemont, IL 60018. Telephone: 847-823-7186. Website: http://aaos.org (accessed November 28, 2015).
* congenital (kon-JEH-nih-tul) means present at birth.
* ultrasound also called a sonogram, is a diagnostic test in which sound waves passing through the body create images on a computer screen.