Clubfoot
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Birth deformities of the foot fall into two categories: 1) Positional deformities -
packaging defects of the foot, and 2) Malformations - manufacturing defects in which the parts
are incorrectly formed. A true clubfoot is a malformation. The bones, joints, muscles, and
blood vessels of the limb are abnormal. The medical term for this is talipes equinovarus -
relating the shape of the foot to a horses hoof. Don’t ask me why!
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Clubfoot can be recognized in the infant by examination. The foot is inturned, stiff
and cannot be brought to a normal position. Children with the condition should be referred to an
orthopedic surgeon for complete evaluation and treatment of the deformity.
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This photo of Taylor below at 3 weeks old with clubfoot shows the foot is inwardly
rotated (towards the toe) and supinated (turned on its side towards the other foot). In walking
position, this child would walk on the outside border of the foot.
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Taylor - 3 weeks old
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The rear view of the foot shows the heel retracted towards the leg (equinus). Note the
medial (inner) crease and curved lateral (outer) border of the foot. This foot cannot be brought
to plantigrade position, meaning flat on the floor.
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The usual treatment of clubfoot is a series of corrective casts applied early in life to stretch
the foot into as corrected a position as possible. Frequently surgery is also needed to release
the stiff and misaligned joints of the foot to make it plantigrade or flat to the floor. The
result of such treatment is usually good with a adequate foot for normal footwear, sports, and
cosmesis. Sometimes later in life or late childhood, there can be pain in the foot necessitating
special shoe modifications such as arch supports, or even additional corrective surgery.
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A true clubfoot is usually stiff and will lack normal motion, be smaller than a normal foot, and
the muscularity of the calf will be noticeably smaller. Sports, exercise, and corrective surgery
can be used to strengthen and realign the foot, but there is always a distinct difference between
the normal side and the clubfoot.
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The treatment of clubfoot is rather involved, and best managed by Orthopedic surgeons
experienced in the techniques mentioned above.
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