Fetal clubfoot
Fetal clubfoot, also known as talipes equinovarus, is a congenital foot deformity in which the foot is curved toward the middle of the body and the toes point downward. It affects the bones, muscles, tendons and blood vessels (of the limb) and can affect one or both feet. The foot is usually short and broad in appearance, and the heel points downward while the front half of the foot, or forefoot, turns inward. The heel can appear narrow and the muscles in the calf are smaller compared to a normal lower leg. Despite its appearance and its name, the affected foot and leg contain all the same bones, muscles, tendons, and anatomic parts as the unaffected limb — only they are misshapen until corrected.
Clubfoot occurs in approximately one in every 1,000 live births and occurs in males twice as often as females. One in every two cases affects both feet.
Diagnosis
Fetal clubfoot can be diagnosed by ultrasound (sonogram) examination prior to birth. Approximately 10 percent of all clubfeet can be diagnosed by 13 weeks gestation, and about 80 percent can be diagnosed by 24 weeks gestation. However, diagnosis based on ultrasound alone produces a 20 percent false positive rate. This is because the normally shaped foot sometimes turns inwards momentarily as the baby wiggles his toes and feet, and if an ultrasound picture is made at that instant the foot appears deformed.
Treatment planning
After a fetus is diagnosed with clubfoot, the orthopedic specialists and nurses at Children's Memorial counsel parents about what to expect when their baby is born and reassure them that the condition is correctable after birth. Parents also meet with the physical therapist before their baby is born to discuss how the stretching and casting is done. Parents are asked to bring their infants for evaluation as early as early as the first few weeks after birth.
Long-term outlook
The long-term outlook for children born with clubfoot is excellent. After treatment, almost all children are able to wear normal shoes and their feet function normally. Most children go on to lead active lives with no residual weakness. In fact, there are numerous children who were born with clubfoot who have gone on to pursue professional athletic careers.
Read about this topic as written in the orthopaedic section of our site.