Treating Clubfoot

What is Clubfoot?

It is a congenital deformity involving one or both feet. The affected foot is turned inwards. About 1 in 1000 babies is born with clubfoot. Children with untreated clubfoot will have pain and difficulty in walking throughout their lives.

The cause of clubfoot is largely unknown. It may be the combination of a few factors acting together (e.g. environment and genetics). Nevertheless, with treatment, the vast majority of patients recover completely during early childhood and are able to carry on normally with their lives.

How is Clubfoot treated?

The Ponseti Method is now a widely accepted treatment option because of its reliability and effectiveness (9 out of 10 are successfully treated). Treatment usually starts within the first week of birth and consists of weekly manipulation and plaster casting of the foot.

On average 5-7 casts are needed although some babies with stiffer feet may need a longer period to obtain correction. Even with casting, the heel-cord tends to remain tight in most babies and will need to be cut (tenotomy). After tenotomy, a cast is applied for another 3-4 weeks.

After cast removal, boots and bar (foot abduction orthosis) are worn for at least 23 hours a day (except during baths) to maintain the corrected position. Full time use of the boots is advised for the first 3 months and then only worn at night or during sleep/nap time until they reach walking age (9-15 months old). Night time use until the age of 4 years is recommended. Compliance is essential as the deformity may recur with inadequate splinting.

Rest assured, your child is very likely to be successfully treated using the Ponseti Method. Minimal or no surgery is necessary, except in the most complicated cases. Talk to an orthopaedic surgeon as soon as possible if your child has clubfoot.

The World Clubfoot Day is celebrated annually around June 3rd as a tribute to Dr Ponseti. The first World Clubfoot Day in Malaysia was held in Kuala Lumpur on 30 May 2015. Organized by Mrs Zarinawati Saad and other parents of children with clubfeet, they have created awareness and provided support for many Malaysian parents. They can be reached through their blog (clubfootmalaysia.blogspot.com).