As a congenital deformity, clubfoot or congenital talipes equinovarus (CTEV) can affect a child’s one foot or both feet. The affected foot of a child looks like being rotated internally at the ankle. The child further finds it difficult to place the sole of the foot flat on the surface. Hence, a child with clubfoot looks like walking on the side of his feet or on his ankles. However, the characteristics and symptoms of club foot differ from one child to another. The parents must start treatment for clubfoot immediately to avoid major problems as the child grows.

1. Clubfoot treatment at
Kids Orthopedic,
Kolkata

2. As a congenital deformity, clubfoot or congenital talipes equinovarus (CTEV)
can affect a child’s one foot or both feet. The affected foot of a child looks like
being rotated internally at the ankle. The child further finds it difficult to place
the sole of the foot flat on the surface.
Hence, a child with clubfoot looks like walking on the side of his feet or on his
ankles. However, the characteristics and symptoms of club foot differ from one
child to another. The parents must start treatment for clubfoot immediately
to avoid major problems as the child grows.

3. About one out of every 1,000 babies is born with a foot that’s twisted. It may
curl sideways with the toes bent at a funny angle. Or, it might have an odd
shape and point in the wrong direction, so that it appears to be crooked, or
even nearly upside down. Doctors call this clubfoot.

4. Most babies who are born with clubfoot are healthy in all other ways; about 1 in
3 of them have it in both feet.
Clubfoot doesn’t cause pain, but if it’s not treated, it can make it hard for a child
to walk without a limp. It’s easy to correct in most cases, so most children don’t
have long-lasting effects.

5. Can It Be Prevented?
Clubfoot happens because the tendons (bands of tissue that connect
muscles to bones) and muscles in and around the foot are shorter than they
should be.

7. Symptoms
In clubfoot, the tendons on the inside of the leg are shortened, the bones have
an unusual shape, and the Achilles tendon is tightened.
If left untreated, the person may appear to walk on their ankles or the sides of
their feet.

8. In an infant born with clubfoot:
• the top of the foot twists downwards and inwards
• the arch is more pronounced and the heel turns inward
• in severe cases, the foot may look as if it is upside-down
• the calf muscles tend to be underdeveloped
• if only one foot is affected, it is usually slightly shorter than the other,
especially at the heel

10. Risk factors for clubfoot
1. Gender. Two-thirds of babies with clubfoot are male.
2. Family history. Babies with a parent or sibling who had clubfoot are twice as
likely to get it.
3. Lifestyle choices. If you smoke or use illegal drugs while you’re pregnant, you
raise your baby’s chances of being born with it.
4. Other birth defects. In some cases, it’s linked with other another condition a
baby is born with, such as spina bifida.
5. Too little amniotic fluid during pregnancy. This surrounds your baby in the
womb. If there’s not enough, your baby’s chances of being born with clubfoot
are higher.

12. Causes
Clubfoot is mainly idiopathic, which means that the cause is unknown. Genetic
factors are believed to play a major role, and some specific gene changes have
been associated with it, but this is not yet well understood. It appears to be
passed down through families.
It is not caused by the fetus' position in the uterus.
Sometimes it may be linked to skeletal abnormalities, such as spina bifida
cystica, or a developmental hip condition known as hip dysplasia, or
developmental dysplasia of the hip (DHH).

13. It may be due to a disruption in a neuromuscular pathway, possibly in the brain,
the spinal cord, a nerve, or a muscle.
Environmental factors may play a role. Research has found a link between the
incidence of clubfoot and maternal age, as well as whether the mother smokes
cigarettes, and if she has diabetes.
A link has also been noted between a higher chance of clubfoot and early
amniocentesis, before 13 weeks of gestation during pregnancy.

15. The condition is immediately visible at birth.
It can also be detected before birth by ultrasound, especially if both feet are
affected. If it is detected before birth, no treatment is possible until after the
baby is born.
Whether the condition is detected during pregnancy or after birth, doctors
will recommend more tests to check for other health problems, such as spina
bifida and muscular dystrophy.
X-rays may help to observe the deformity in more detail.
Diagnosis

17. Treatment
The causes and symptoms of clubfoot differ from one child to another. The
orthopaedic treat the congenital deformity in a number of ways. But they always
decide the right clubfoot treatment method based on the symptoms and causes.
Initially, the orthopaedic treat clubfoot through Ponseti method which includes
both stretching and casting.
However, they perform invasive surgery if the nonsurgical treatment failed. They try
to straighten the twisted foot by lengthening the child’s tendons through surgery.

18. Dobbs Clubfoot (CTEV)
Dynamic Bar
Bar Attribute Regular (over 12 months), Small (under 12 months old)

19. Clubfoot Shoes for
Dobbs Bar

20. Static Foot Abduction
Brace (Steenbeek) for
Clubfoot (CTEV)

22. Recovery
The recovery period of clubfoot treatment differs based on the treatment option.
The nonsurgical treatment methods require the child to wear special shoes and
braces fulltime till the clubfoot is cured. Also, the child has to perform a variety of
stretching exercises on a daily basis.
However, the parents must make the child wear special shoes and braces or perform
stretch exercise based on the doctor’s direction. On the other hand, the child will in
a cast for up to two months, and wear a brace for about one year after the surgery.
The cast and brace will prevent the clubfoot from coming back.

23. Paediatric orthopaedics is a specialized branch of orthopaedics surgery which
deals with musculoskeletal problems (bone, joint and muscle) in a child who is
still growing. It also includes musculoskeletal problems of young adults, which
are squeal of their childhood disease.
Dr. Soumya Paik treats with Culbfoot in children.