Clubfoot is a congenital disorder that occurs in 1 out of 1,000 births per year. In newborns, the condition causes the foot to appear as if it is rotated incorrectly at the ankle. Several different factors cause clubfoot. Normally, clubfoot occurs due to genetics; however, some environmental factors are a possibility as well. Breech presentation and the position of the baby in a womb can cause clubfoot, as well as certain connective tissue disorders. This abnormality is often noticed during an ultrasound of the pregnancy at the 20th week.
A common treatment of clubfoot is reshaping. This procedure should be done shortly after a child is born. The foot or feet are put into place and then casted on the legs for stability. Required check-ups occur once a week to stretch and recast the feet. This process is done for about 5-10 weeks. Afterwards, one more cast is placed on for 3 weeks. Once positioned correctly, a child needs to wear a brace day and night for 3 months. For the next 3 years, while sleeping, the brace must be worn. These steps are taken to prevent the feet from reverting back to its misshapen position.
While this non-surgical approach has been proven very successful, severe cases of clubfoot may require surgery. Clubfoot surgery is usually performed after nine months of age. If surgery is performed, corrective shoes or a brace must be worn for up to a year afterwards as a supplemental measure. Secondary or repeat surgeries may also be needed to correct scar tissue damage as the child grows. In rarer cases, a surgical procedure may be needed as an adult.