Clubfoot is a condition where one or both feet are positioned rotating inward or downward in a mild or severe manner. The affected foot may also be smaller than usual, particularly in the heel area. It is usually congenital and may even be visible in an in-utero ultrasound. Clubfoot does not cause pain and can be corrected with proper treatment early on.

Clubfoot affects about one in 1,000 babies, making it one of the most commonly-occurring, non-deadly major birth defects. Almost 50% of clubfoot babies have two clubbed feet, and two-thirds of clubfoot babies are males. The condition can occur due to the in-utero positioning of a forming baby or a combination of environmental and genetic factors. If a family member has clubfoot, it increases an infant’s odds of having it.

Treatment of clubfoot should begin immediately to avoid growth problems as well as subsequent discomfort and disability. If treated before a baby walks, function and stability can be greatly improved. Serial casting is a common treatment for clubfoot that gradually shifts the bones into proper alignment. Over several months, the doctor intermittently stretches the foot toward the proper position, then casts it to hold the new position in place. X-rays show progress.

After successful serial casting, the child will need to wear special shoes or braces for several years to maintain proper foot positioning. Frequently, the muscles will try to return to the pre-treatment position until about mid-childhood. If serial casting is not successful, the joints, ligaments, and tendons can be surgically shifted.