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Clubfoot

Clubfoot describes a range of foot abnormalities usually present at birth (congenital) in which your 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. The term "clubfoot" refers to the way the foot is positioned at a sharp angle to the ankle, like the head of a golf club. Clubfoot is a fairly common birth defect and is usually an isolated problem for an otherwise healthy newborn.

Clubfoot can be mild or severe. About half of children with clubfoot have it in both feet. If your child has clubfoot, it will make it hard for him or her to walk normally, so doctors generally recommend treating it soon after birth.

Doctors are usually able to treat clubfoot successfully, though sometimes children need follow-up surgery later on.

Symptoms Causes Risk factors Complications Prevention

If your child has clubfoot, his or her foot may have the following appearance:

  • The top of the foot is usually twisted downward and inward, increasing the arch and turning the heel inward.
  • The foot may be turned so severely that it actually looks as if it's upside down.
  • The calf muscles in the affected leg are usually underdeveloped.
  • The affected foot may be up to 1/2 inch (about 1 centimeter) shorter than the other foot.

Despite its look, however, clubfoot itself doesn't cause any discomfort or pain.

When to see a doctor

More than likely your doctor will notice clubfoot soon after your child is born, based on appearance. You'll likely be advised on the most appropriate treatment.

The cause of clubfoot is unknown (idiopathic). But scientists do know that clubfoot is not caused by the position of the baby in the womb (fetus). In some cases, clubfoot can be associated with other abnormalities of the skeleton that are present at birth (congenital), such as spina bifida, a serious birth defect that occurs when the tissue surrounding the developing spinal cord of a fetus doesn't close properly.

The environment plays a role in causing clubfoot. Studies have strongly linked clubfoot to cigarette smoking during pregnancy, especially when there already is a family history of clubfoot.

Risk factors include:

  • Sex. Clubfoot is more common in males.
  • Family history. If either one of the parents or their other children have had clubfoot, the baby is more likely to have it as well. It's also more common if the baby has another birth defect.
  • Smoking during pregnancy. If a woman with a family history of clubfoot smokes during pregnancy, her baby's risk of the condition may be 20 times greater than average.
  • Not enough amniotic fluid during pregnancy. Too little of the fluid that surrounds the baby in the womb may increase the risk of clubfoot.
  • Getting an infection or using illicit drugs during pregnancy. These can increase the risk of clubfoot as well.

Clubfoot typically doesn't cause any problems until your child starts to stand and walk. If the clubfoot is treated, your child will most likely walk fairly normally. He or she may have some difficulty with:

  • Mobility. Your child's mobility may be slightly limited.
  • Shoe size. The affected foot may be up to 1 1/2 shoe sizes smaller than the unaffected foot.

However, if not treated, clubfoot causes more-serious problems. These can include:

  • Arthritis. Your child is likely to develop arthritis.
  • Poor self-image. The unusual appearance of the foot may make your child's body image a concern during the teen years.
  • Inability to walk normally. The twist of the ankle may not allow your child to walk on the soles of the feet. To compensate, he or she may walk on the balls of the feet, the outside of the feet or even the top of the feet in severe cases.
  • Muscle development problems. These walking adjustments may prevent natural growth of the calf muscles, cause large sores or calluses on the feet, and result in an awkward gait.

Because doctors don't know what causes clubfoot, you can't completely prevent it. However, if you're pregnant, you can do things to limit your baby's risk of birth defects, such as clubfoot, including:

  • not smoking or spending time in smoky environments
  • not drinking alcohol
  • avoiding drugs not approved by your doctor
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