The best treatment for early clubfoot is serial casting using the Ponseti technique. Studies show that there is less long term stiffness and pain compared to surgical intervention. There is some argument on when to begin casting. Some studies have suggested that casting begin at 1 month; however, we have excellent results when casting begins at 4-7 days following birth as originally described by Ponseti. It is common to perform a percutaneous Achilles tenotomy after a series of casts to reduce the equinus deformity.
Dr. McCall has over 10 years of treating clubfoot deformity and offers world class treatment close to home.
*Descriptive Epidemiology of Idiopathic clubfoot
Werler, Martha M. et al, Am J Med Genet A. 2013 july; 161(7): 1569-1578
Amniocentesis ≤ 16 weeks (5.6).
Clubfoot is a common structural malformation occurring in 1/1000 live births. The cause of clubfoot is unkown; however, a recent epidemiological evaluation of North America revealed the following:
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Pregnancy related conditions include:
Positive associations with high bmi were confined to cases where too much pressure was on the fetus (low amniotic fluid, breech delivery, bicornuate uterus, plural birth), inheritance (family history in 1st degree relative), or blood supply disruption (early amniocentesis, cvs, plural gestation with fetal loss).*
The cases were more likely to be male (Odds Ratio 2.7).
Babies born to first time mothers (1.4).
Mothers with bmi ≥ 30 kg/m^2 (1.4).
Clubfoot is easy to identify. The foot is usually bent down and toward the body. The Achilles tendon is very tight making it difficult to raise the foot at the ankle. The foot is twisted, often severely enough that the bottom of the foot faces up.
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