Most commonly, a doctor recognizes clubfoot soon after birth just from looking at the shape and positioning of the newborn's foot. Occasionally, the doctor may request X-rays to fully understand how severe the clubfoot is, but usually X-rays are not necessary.
It's possible to clearly see some cases of clubfoot before birth during an ultrasound exam. While nothing can be done before birth to solve the problem, knowing about the condition may give you time to learn more about clubfoot and get in touch with appropriate health experts, such as a genetic counselor or an orthopedic surgeon.
Because your newborn's bones, joints and tendons are very 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)
Stretching and casting (Ponseti method)
This is the most common treatment for clubfoot. Your doctor will:
- Move your baby's foot into a correct position and then place it in a cast to hold it there
- Reposition and recast your 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 your baby's foot is realigned, you'll 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 this procedure sometimes doesn't work is because the braces are not used constantly.
If your baby's clubfoot is severe or doesn't respond to nonsurgical treatments, more invasive surgery may be needed. 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.
Preparing for your appointment
If your baby is born with clubfoot, he or she will likely be diagnosed soon after birth. In some cases, your baby's doctor may refer you to a pediatric orthopedist.
If you have time before meeting with your child's doctor, make a list of questions. Your time with the doctor may be limited, so it helps to be prepared. Here are some questions to consider asking:
- Do you commonly treat newborns with clubfoot?
- Should my child be referred to a specialist?
- What types of corrective treatment are available?
- Will my child need surgery?
- What kind of follow-up care will my child need?
- Should I get a second opinion before beginning my child's treatment? Will my insurance cover it?
- After treatment, will my child be able to walk normally?
- Are there any printed materials that I can have? What websites do you recommend?
In addition, tell your doctor:
- If you have family members — including extended family — who've had clubfoot
- If you had any medical issues or problems during your pregnancy