Because your newborn's bones and joints are extremely flexible, treatment for clubfoot usually begins in the first week or two after birth. The goal of treatment is to improve the way your child's foot looks and works before he or she learns to walk, in hopes of preventing long-term disabilities. Treatment options include:
Stretching and casting (Ponseti method)
This is the most common treatment for clubfoot. The doctor will do the following:
- Move the baby's foot into a correct position and then place it in a cast to hold it in that position
- Reposition and recast the baby's foot once or twice a week for several months
- Perform a minor surgical procedure to lengthen the Achilles tendon (percutaneous Achilles tenotomy) toward the end of this process
After the shape of the foot is realigned, parents will need to maintain it by doing one or more of the following:
- Doing stretching exercises with your baby
- Putting your child in special shoes and braces
- Making sure your child wears the shoes and braces as long as needed — usually full time for three months, and then at night for up to three years
For this method to be successful, you'll need to apply the braces according to your doctor's directions so that the foot doesn't return to its original position. The main reason that this procedure sometimes doesn't work is because the braces are not used constantly.
Stretching and taping (French method)
This approach is also called the functional method or the physiotherapy method. Working with a physical therapist, parents:
- Move the foot daily and hold it in position with adhesive tape
- Use a machine to continuously move the baby's foot while he or she sleeps
- After two months, cut treatment back to three times a week until the baby is 6 months old
- Once the shape is corrected, continue to perform daily exercises and use night splints until the baby is of walking age
This method requires a much greater time commitment than does the Ponseti method. Some caregivers combine the French method and the Ponseti method.
In some cases, when clubfoot is severe or doesn't respond to nonsurgical treatments, babies may need more invasive surgery. An orthopedic surgeon can lengthen tendons to help ease the foot into a better position. After surgery, your child will be in a cast for up to two months, and then need to wear a brace for a year or so to prevent the clubfoot from coming back.
Even with treatment, clubfoot may not be totally correctable. But in most cases babies who are treated early grow up to wear ordinary shoes and lead normal, active lives.
Mar. 22, 2013
- AskMayoExpert. Can clubfoot be diagnosed in utero? Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2012.
- AskMayoExpert. Is further surgical intervention needed for congenital clubfoot? Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2012.
- AskMayoExpert. Are other medical conditions associated with congenital clubfoot? Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2012.
- AskMayoExpert. Why should a patient be referred to a pediatric orthopedic surgeon for the treatment of congenital clubfoot? Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2012.
- AskMayoExpert. What is the usual treatment for congenital clubfoot? Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2012.
- AskMayoExpert. Clubfoot: Key facts. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2012.
- Kliegman RM, et al. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, Pa.: Saunders Elsevier; 2011. http://www.mdconsult.com/das/book/body/208746819-6/0/1608/0.html. Accessed Feb. 6, 2013.
- Canale ST, et al. Campbell's Operative Orthopaedics. 11th ed. Philadelphia, Pa.: Mosby Elsevier; 2008. http://www.mdconsult.com/das/book/body/208746819-4/0/1584/0.html. Accessed Feb. 5, 2013.
- Bridgens J, et al. Current management of clubfoot (congenital talipes equinovarus). BMJ. 2010;340:c355.
- Birth defects. March of Dimes. http://www.marchofdimes.com/baby/birthdefects_clubfoot.html#. Accessed Feb. 6, 2013.
- Dobbs MB, et al. Update on clubfoot: Etiology and treatment. Clinical Orthopaedics and Related Research. 2009;467:1146.