Clubfoot, also known as talipes equinovarus, is a congenital condition where a baby's foot is twisted out of shape or position. In clubfoot, the tissues connecting the muscles to the bone (tendons) are shorter than usual, causing the foot to turn inward and downward. This results in the affected foot or feet appearing rotated internally at the ankle, with the sole of the foot facing inward or even upward.
The exact cause of clubfoot is not always known, but it's believed to involve a combination of genetic and environmental factors. It can occur in one or both feet and may vary in severity from mild to severe.
Clubfoot is typically diagnosed at birth or shortly after, during a physical examination. Treatment usually begins soon after diagnosis and may involve gentle manipulation and stretching of the foot followed by casting to gradually correct the foot's position. In some cases, surgery may be required to release tight tendons or to reposition bones. After the correction phase is over, a Foot Abduction Brace is given to a child for a period of 5 Years which helps maintain the corrected foot position and prevent relapse.
When a child is born with the foot twisted inward and upward it is clubfoot. Since the foot looks like a golf club, it is called ‘clubfoot’. Clubfoot is always present at birth. It never occurs after birth. Some children have clubfoot deformity in one foot (unilateral) and the other foot is normal and others have clubfoot in both their feet (bilateral). The ratio between unilateral and bilateral foot is 50:50. Globally clubfoot among boys is more compared to the number of girls born with clubfoot. The ratio is around 60:40 among boys and girls respectively. It is estimated that over 2,20,000 children are born with clubfoot in low-income countries every year. The number of children born with clubfoot in each country by and large depends on the population and the birth rate. One or two children per thousand live births are born with clubfoot. However, there could be other specific reasons for higher numbers of children born with clubfoot in different countries.
The technical term for clubfoot is Congenital Talipes Equino Varus (CTEV). Talipes refers to ankle and foot, equino refers to elevated heel and varus refers to turned inward. Congenital means by birth; and talipes, equino and varus are referred to because they are all found deformed in a clubfoot.
There are four areas that are corrected in the same sequence as the acronym ‘CAVE’. Cavus, Adductus, Varus and Equinus. Cavus is corrected first by supinating the foot and Adductus is corrected by abducting the foot and in this process of correcting Cavus and Adductus, Varus position of calcaneus is automatically corrected to valgus and finally Equines is corrected with tenotomy.
The cause of clubfoot is unknown. So, no one can blame either mother or father or anyone else in the family for the child to have been born with this deformity.
Among parents who have clubfoot the chances of getting a child born with clubfoot is only 15%. There are many theories on the reasons for clubfoot but till now no theory has been proved to be the only reason for the cause of clubfoot.
The treated foot is maintained using a foot abduction brace (FAB) for four to five years. If the foot is not maintained in the corrected position, the foot relapses and comes to the original clubfoot position. If the clubfoot is left untreated it leads to lifetime deformity. But if treated with the right method at an early stage ( preferably start treatment soon after the birth [but definitely] within the first two to three months) the treatment becomes easy and the child can lead a normal and productive life. The aim is to get the treatment started soon after birth, so that by the time the child is ready to walk the foot is completely corrected and the child has to wear only night and naptime brace.
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