Diagnosis of clubfoot is becoming common in utero, as more women have ultrasounds during their pregnancies. Improvements in ultrasound images also help with prenatal diagnosis. For those not diagnosed during pregnancy, club foot can be diagnosed by a medical examination after birth.

Is it genetic or heritable? 

This defect does seem to have an increased incidence in families with a history of clubfoot or other orthopedic problems. Family history could include a parent who had clubfoot at birth or a congenital hip dysplasia (which is the underdevelopment of the bones of the pelvis, especially the hip joints) or a blood relative with similar defects.

If your child has clubfoot, your obstetrician likely will refer you to a maternal-fetal medicine specialist (a doctor who handles high-risk pregnancies). Your maternal-fetal medicine specialist will do a more extensive ultrasound to confirm the diagnosis and look for any other anomalies your child may have.

How will it affect my baby?

Clubfoot is not painful for your baby. It really has no effects on your newborn. However, it does need to be corrected, as it will not resolve on its own. Your child will not be able to walk normally with untreated clubfoot because they will not be able to place the affected foot (or feet) flat on the floor.

How will it affect my pregnancy?

There is no prenatal treatment for clubfeet. But, if you know about the diagnosis prior to delivery, you will have a chance to locate an orthopedic surgeon who is familiar with treating clubfeet and learn about treatment options.

The majority of babies who have clubfoot will not have other problems. There are a few birth defects that can be accompanied by clubfeet, so we recommend a thorough exam of your baby using a level II ultrasound.

Isolated clubfeet will not affect your pregnancy. However, if your child has another birth defect that accompanies clubfeet, you may need more frequent monitoring to evaluate your child's well-being during the pregnancy.

Until very recently, the routine treatment for clubfoot was serial casting and surgery. However, a nonsurgical technique has proved to provide better results without the risks of surgery. This method is called the Ponseti Method, after the doctor who first used it in the 1950s.

This method gained popularity once the babies who were first treated grew up and proved that this method provides better results than the traditional surgical method does. The Ponseti Method is a multi-step, multi-visit process that begins shortly after birth, when the tendons are more flexible.

Steps in the Ponseti Method

1. At first, doctors gently massage and manipulate the clubfoot. This stretches and contracts the tissue.
2. Following the massage and manipulation, doctors place a thin plaster cast (or casts), with the foot (or feet) positioned in the more stretched position. The cast extends from the toe to the groin.
3. Doctors change the cast(s) every five to seven days. With each casting, doctors repeat the massage and manipulation and apply a new cast to the stretched foot. This process typically continues for five or six casting sessions.
4. Before doctors apply the last cast, 90-95% of these babies will require a tenotomy. This procedure releases or cuts the Achilles tendon to help correct the clubfoot deformity. Some surgeons will do the tenotomy in the clinic if the clubfoot is only on one side, but most of the time, the tenotomy is done in the hospital under general anesthesia for the comfort of the patient. It is outpatient surgery and the child will go home the same day.
5. Once doctors have removed the final cast, they fit the children with a special type of splint. This splint includes a pair of shoes connected to each other by a metal bar attached to the bottom of the shoes. The shoes are rotated away from the body. The child must wear the splint for 23 hours a day for three months and then at night and during naps (10-12 hours per day) for the next two to four years.

Reported success rates with the Ponseti Method vary greatly. Doctors successfully correct approximately 50-90% of children with clubfeet without surgery.

However, if non-operative treatment (like the Ponseti Method,) is not effective, a child may still need surgery. A decision of if surgical correction is needed is individualized and aimed at treating only those who require surgical intervention. If surgery becomes necessary for your child, their orthopedic surgeon will explain what type of procedure should be performed.

Expert pediatric care: At Children’s Wisconsin, our Orthopedics Program specializes in all areas of orthopedic care, from upper extremity, trauma, spine and fracture care to sports medicine and concussion management. We treat all orthopedic conditions, from routine to serious. Kids are not just little adults, and require unique, individualized care for their developing little bodies. Our doctors are pediatric experts and every doctor specializes 100% in kids and teens.