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Definition  

Clubfoot is a deformity of the foot that causes the foot to turn inward and downward. The Achilles tendon becomes tight, which pulls the heel upward toward the leg and prevents the foot from being able to sit flat on the ground. A clubfoot is usually smaller than a normal-sized foot.

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Achilles Tendon and Related Muscles  
Achilles Tendon action

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Causes  

Clubfoot is caused by a deformity in the development of the muscles, tendons, and bones of the foot. It is present at birth. The cause of clubfoot is unknown. There is some belief that clubfoot can be inherited in some cases. It is not thought to be caused by position in the womb.

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Risk Factors  

Because the cause of clubfoot is not understood, not many of the risk factors for this condition are known. However, some of the following factors may increase your chance of developing clubfoot:

  • Sex: male
  • Having a family history of clubfoot
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Symptoms  

Symptoms include:

  • At birth, one or both feet that:
    • Turn inward and downward, and will not straighten
    • Are slightly smaller than normal
  • Calf muscle slightly smaller than normal
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Prenatal Ultrasound  
Fetal Ultrasound

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Diagnosis  

Clubfoot is easily diagnosed during a physical examination, but an x-ray of the foot will also be taken. The condition can often be diagnosed before birth during an ultrasound examination.

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Treatment  

Clubfoot can be corrected, but it is best to start treatment as early as possible—sometimes right after birth. Treatment options include:

Casting  

With casting, the foot is manually moved into a better position. It is placed in a series of casts. A new cast is put on every week for 5-10 weeks to stretch the soft tissues of the foot and reshape it.

After the initial casting procedure is completed, a brace is used at night and during naps.

Surgery  

More extensive surgery may be done to correct the deformed tendons and muscles in severe cases that do not respond to casting. When necessary, surgery is most commonly done within the first year of life.

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Prevention  

There is no known way to prevent clubfoot, because the cause is unknown.