A clubfoot is a deformity of the foot that is usually present at birth. It occurs in approximately one per 1000 live births making it a relatively frequent condition. When a baby is born the midwife or doctor is going to check them for several different problems as part of the screening routine. A clubfoot is one of those problems that they typically search for. A clubfoot is described as when the foot is in a downward and inward position as compared with normal. This is technically generally known as planterflexed, inverted and abducted placement of the foot. In the grand scheme of things a clubfoot is usually comparatively minor condition but still may be very distressing at the birth because it is visible. Often, it's an isolated problem, but sometimes it is part of a range of symptoms making up a syndrome. Babies with this deformity will also be more prone to have a dislocated hip at birth.
The management of a clubfoot is dependent upon the severity and characteristics of it. There are generally two types of clubfoot; flexible and rigid. A flexible clubfoot is frequently managed with regular mobilization, manipulation and stretching out and then the foot is put into a plaster cast to hold it in a more changed position. After a period of time, that could depend on how serious it is, the plaster cast is taken off and the foot is again mobilized and stretched with a new plaster cast being applied and then to hold the foot in an much more corrected position. This process has been well documented to be generally quite effective. If this therapy is not successful or if the deformity is rigid then a surgical strategy is indicated. Technically this is a challenging surgery as the foot and structures are very small. There are plenty of structures from the bone, to the tendons, to the ligaments that have to be operated on to move the foot in to a much more corrected position, making it complicated.