Clubfoot, formally known as talipes equinovarus, is a common birth defect that causes the foot to turn in and down so that it can't be placed in the normal position, according to MedlinePlus. Sometimes the foot and calf are also smaller than normal, or both feet are affected. The problem can also affect the foot bones, muscles, ligaments and ankles. Clubfoot is the most common birth defect affecting the legs and occurs in one of every 1,000 babies. Most of the time, it can be treated without surgery.
Casting
The most common method of treating clubfoot is with manipulation and casting, according to the March of Dimes. Casting works by moving the foot into the right position and using a cast to keep it there, according to MedlinePlus. This treatment works best when started as soon as possible after birth; that's when reshaping the foot is easiest. An orthopedic specialist gently stretches the foot a little closer to the proper alignment each week and casts it to keep it in position. After five to 10 weeks of gradual improvements, the foot should be properly aligned and a final cast kept on for three weeks. Then a brace is fitted for the baby to keep the foot in the right position for the long term. The brace is worn full time for three months, then the amount of time is gradually reduced.
Physical Therapy
Another approach is to have physical therapy and family members manipulate the baby's foot each day for about two months, according to the March of Dimes. After each therapy session, the foot is taped to hold it in the correct position. After the first couple of months, therapy sessions are gradually tapered off over six months. Once physical therapy is complete, the baby is given a splint to wear at night until he reaches walking age. Sometimes this approach is used in combination with casting.
Surgery
Most of the time, casting works. But in severe cases, or when the problem returns after casting, surgery may be needed, according to MedlinePlus. Several types of surgery are used, depending on severity. In the simplest procedures, the surgeon makes some small cuts around the ankle and foot. This allows him to lengthen or shorten the tendons as needed so that he can maneuver the bones and joints into the correct position. The child has to wear a cast after surgery to keep the foot in the right position while it heals. Sometimes this doesn't completely repair the problem, or a child who hasn't had surgery needs it once he grows. In that case, surgeons may remove part of the bone or fuse two or more bones together to repair the foot. Also, sometimes metal pins or plates are surgically implanted to hold the bones in the proper position.
