Clubfoot is the most common congenital disorder of the lower extremity. It can range from mild and flexible to severe and rigid. In all forms the foot turns downward and inward. Genetic and environmental factors in the development of the fetus are the apparent causes. One or both feet may be affected. Risk factors include a family history of the disorder and being male. The incidence is 1 per 1,000 live births.

The physical appearance of the deformity may vary.

• one or both feet may be affected
• foot turns inward and downward at birth
  • tight in deformed position and resists realignment
• calf muscle may be smaller and underdeveloped

Physical examination confirms the presence of the disorder.

A foot X-ray (extremity X-ray) may be performed.

Treatment should be initiated as early as possible.

Clubfoot deformities may be corrected by manipulating the foot into a correct position, and casting the foot to maintain the correction. This is often done by an orthopedic specialist. The treatment is started early in the newborn when the foot is easiest to reshape. Repositioning and recasting occurs every few weeks to improve the position of the foot. After the shape of the foot is realigned, it is maintained through exercise, splints at night, and orthopedic shoes. Correction using this approach takes about 3 months.

Some severe deformities will require surgery if manipulation does not achieve correction. Continued evaluation is recommended until the foot is fully grown.

Some defects may not be totally correctable, but with treatment the appearance and function of the foot can be improved.

If treated for clubfoot, call your health care provider if swelling, bleeding, or change in color of the toes occurs under the cast, if the toes disappear into the cast; or if the foot begins to turn in again after treatment.