Club foot

Club foot is a deformity of the foot and ankle that babies can be born with. The position and function of the foot can be greatly improved, if treated early.

The foot of a baby with club foot points down and inwards, with the soles of the feet facing backwards.

Club foot isn’t painful for babies, but it can become painful as they get older and cause difficulties walking if it isn’t treated.

Club foot is relatively common, affecting around one baby in every 1,000 born in the UK. Both feet are affected in around half of the children born with the condition.

The medical name for club foot is congenital talipes equinovarus.

What causes club foot?

In most cases the cause of club foot is unknown, although there may be a genetic link because it can run in families.

If you have one child with club foot, your risk of having a second child with the condition is around one in 35.

If one parent had the condition as a baby, there is around a one in 30 chance of their children having the condition. If both parents previously had the condition, this increases to around a one in three chance.

In a small number of cases, club foot occurs as part of a more serious underlying condition affecting the baby's development, such as spina bifida.

Diagnosing club foot

Club foot is usually diagnosed after a baby is born, although the problem may first be spotted during the routine ultrasound scan carried out between 18 and 21 weeks of pregnancy.

It cannot be treated before birth, but picking up the problem during pregnancy means you can talk to doctors about the condition in detail and find out what to expect after your baby is born.

Further tests may also be carried out while you're pregnant, to check for conditions such as spina bifida.

How club foot is treated

Treatment for club foot should ideally start within a week or two of the baby being born, but it can still be effective if started later in childhood.

A technique known as the Ponseti method is the main treatment for club foot nowadays. This involves your baby's foot being gently manipulated into a better position and then being put in a cast. This is repeated weekly for around five to eight weeks.

After this stage, it's likely that your baby will need a minor procedure (carried out using a local anaesthetic) to make a small cut in their Achilles tendon. This can help to release their foot into a more natural position.

Your baby will need to wear special boots attached to each other with a bar, to prevent club foot returning. These are only worn full-time for the first three months, then overnight until your child is four or five years old.

Outlook

The vast majority of children treated with the Ponseti method will have pain-free, normal-looking feet that function well. Most children are able to learn to walk by the usual age and can participate in activities such as sports when they're older.

Some children may be left with a slightly shorter leg and smaller foot on one side if only one of their feet was affected. This won't usually cause any significant problems, but it may mean that your child will be slightly less mobile and may get tired quicker than other children.

Before the Ponseti method was widely adopted, club foot was often treated with surgery to alter the position of the foot. This wasn't always effective and lead to long-term pain and stiffness for some adults.