The Center for Podiatric Care and Sports Medicine

What to Expect and What to Do When Your Baby Has Club Feet

Posted by on Wednesday, August 7th, 2013

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Clubfoot is a heart-breaking condition that affects 1 out of 1,000 babies, and ranges from mild to severe. Sometimes the heel is smaller than usual and the foot points downward. Other times, the front of the foot is rotated horizontally to face the other foot. In almost half of infants with the condition, both feet are affected. The causes for clubfoot in babies are not well known. Some believe it is a structural defect that occurs due to the positioning of the baby in the womb, while others suspect genetic factors are involved. Clubfoot may also be linked to spina bifida or traumatic injury. It is not the sort of deformity that can correct itself. Fortunately, doctors have seen success with early treatment that begins right after birth.

Clubfoot: One Baby’s Story

In St. George, Utah, Kenzlie Kelton was born with a lung infection, heart murmur and clubfoot. After nine days in the intensive care unit, she was placed in a corrective cast to start her treatment. A casting technique called the Ponseti method is said to work in 90 out of 100 children with clubfoot. So, her cast was replaced once a week over the next eight weeks to realign the foot into the proper position.

A surgical procedure called “a tendon release” was performed on her Achilles tendon to decrease tension. She then went into a brace for three months. Two weeks later, the foot was not healing straight and the doctors had to perform another tendon release, followed by casting for another five weeks.

A third round of casting still awaits, along with weekly checkups over the next six weeks. From there, she will still require surgery and will need to wear a night brace for an undetermined amount of time. Baby Kenzlie won’t be able to walk until her tendon is fully healed, says her mother, Ashley. “I feel like we are at the doctor’s all the time,” she adds. The family hopes Kenzlie will be able to develop normally once the procedures are done. However, the surgery may not be covered by insurance.

When Casting Doesn’t Work: Should You Opt For Bracing Or Surgery?

Casting should alleviate the child’s condition within two or three months. However, if that doesn’t work, bracing is the secondary line of treatment offered to parents. The success rate is 95% — if the doctor’s instructions are followed accurately, but it’s a long and difficult road to recovery. This means the infant will need to wear a special brace 23 hours a day for three months and then at nighttime for three to four years. The most popular braces include the Markell Abduction Brace (top photo) and the Mitchell Abduction Brace (bottom photo). If the braces are not worn as directed, there is almost a 100% recurrence rate.

Clubfoot Surgery

Between six months and a year, surgical intervention becomes an option. Wires are used to hold the joints in place during this procedure. The likelihood of requiring additional surgery ranges from five to 50%, according to the American Academy of Orthopaedic Surgeons. Following surgery, the infant will still need to wear a long-leg cast with the knees bent at a 90 degree angle for six weeks. The cast will then be removed and the pins pulled. At this point, a short cast will be worn for another four weeks. Over the next few months, splints or special shoes may be required to continue healing.

Please note: Here at the Center for Podiatric Care and Sports Medicine in NYC, clubfoot deformity correction is one of our specialties.

 

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If you have any foot problems or pain, contact The Center for Podiatric Care and Sports MedicineDr. Josef J. GeldwertDr. Katherine Lai, Dr. Ryan Minara and Dr. Mariola Rivera have helped thousands of people get back on their feet. Unfortunately, we cannot give diagnoses or treatment advice online. Please make an appointment to see us if you live in the NY metropolitan area or seek out a podiatrist in your area.