Clubfoot explained: Presentation, risks, and treatment

Clubfoot or CTEV is a congenital foot deformity causing inward twisting. Learn its causes, risk factors, diagnosis, and Ponseti treatment approach. (Image: Pexels)

Congenital talipes equino varus, also called club foot or CTEV, is a congenital deformity of the foot that has four major components, cavus, which is the high medial arch, adduction of the foot, varus (oblique displacement of the limb) of heel and equinus at the ankle. The foot of the child appears twisted inward, as well as downward, which may lead to long-term disability and difficulty in waking due to gait abnormalities.

Who Is at Risk?

CTEV is more common in males as compared to females, and nearly fifty percent of the cases are bilateral. It can either be seen as an isolated deformity, or may be associated with neuromuscular conditions like spina bifida. Recurrence risk is common in case of a positive family history.

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Why Clubfoot Occurs: Understanding the Causes

While the exact cause of clubfoot is not known, it may have a multifactorial etiology. Genetics, environment and intra-uterine factors may influence the development of CTEV.

This deformity involves not only the bones, but also the muscles, tendons, and ligaments.

The parents usually observe the baby’s foot as being twisted inward and downward at birth. In the initial stages, it is painless, however, once the child begins walking, symptoms like difficulty wearing footwear and an abnormal gait may be noticed. Pain may occur because of weight-bearing on the outer side of the foot.

How Doctors Diagnose CTEV

On examination, the foot appears small and stiff, and has a characteristic deformity. The medial arch is exaggerated, and there is some restriction of movement in the ankle. The calf muscles may be underdeveloped up in some cases. If left untreated, CTEV can lead to severe disability and persistent deformity, which can causes callosities and malalignment of the knee and hip. Adults may experience symptoms of arthritis and chronic pain along with breakdown of lateral foot skim because of abnormal weight-bearing.

Also Read: What is Clubfoot and how to prevent it? Expert explains 

Treatment Options

The Ponseti method is the gold standard treatment for club foot, and involves sequential manipulation with casts that can aid in bringing the foot to near normal position.

Surgical treatment is limited for children whose treatment has been neglected, or if there is a relapse of the condition.

With early Ponseti, the outcome is favourable and children can achieve normal gait and activity.

FAQs on Clubfoot

1. What is clubfoot?

Clubfoot, or congenital talipes equinovarus (CTEV), is a congenital deformity where the foot appears twisted inward and downward.

2. Who is at risk for clubfoot?

Clubfoot is more common in males and can be bilateral. It may also be associated with conditions like spina bifida and is more likely if there's a family history.

3. What causes clubfoot?

The exact cause is unknown but is believed to be multifactorial, involving genetics, environment, and intrauterine factors.

4. How is clubfoot diagnosed?

Doctors diagnose clubfoot through physical examination, noting the small and stiff foot with exaggerated medial arch and restricted ankle movement.

5. What are the treatment options for clubfoot?

The Ponseti method, involving sequential manipulation with casts, is the gold standard. Surgery is limited to neglected cases or relapses. Early treatment usually leads to a favourable outcome.

Disclaimer: This article, including health and fitness advice, only provides generic information. Don’t treat it as a substitute for qualified medical opinion. Always consult a specialist for specific health diagnosis.