Clubfoot: Information & clubfoot specialists

Clubfoot is a serious deformity of the foot that causes severe limitations for those affected. The lower leg muscles may also be deformed. There are both congenital and acquired clubfoot. The causes of congenital clubfoot have not yet been conclusively clarified. In both forms, early therapy is indicated to restore physiological movement. The therapy consists of both conservative and surgical approaches. The congenital form of clubfoot is already very pronounced and visible at birth.

Here you will find further information as well as selected clubfoot specialists and centers.

How does a clubfoot develop and what types are there?

The reasons for the development of congenital clubfoot are not clear. It can be both congenital and acquired in the course of life.

In the case of congenital clubfoot, certain muscle groups are not fully developed during pregnancy.

In an acquired clubfoot, on the other hand

• injuries,
• neurological diseases and
• degeneration of nerves or tendons in the lower leg can play a central role.

can play a central role.

Trauma to the lower leg can lead to nerve injuries and subsequently to nerve failure.

If the nerves fail, the muscles that this nerve innervates can no longer be controlled. This results in a loss of function.

Many muscles of the lower leg have a stabilizing function on the arch of the foot. Loss of this function and atrophy of the muscles can lead to foot deformities, including an acquired clubfoot (due to the trauma).

The complex deformity of clubfoot is made up of several individual deformities that affect the various joints of the foot.

Sickle foot

Sickle foot is the most common foot deformity in infants. It involves a deviation of the toes inwards in the forefoot.

Not only the midfoot is affected, but also the toes. This deformity can either regress on its own or be corrected with the help of suitable therapies.

Pointed foot

Pointed foot is a condition in which the affected person cannot place the heel completely on the ground. In other words, they walk on their toes, which gives this foot deformity its name.

Children and older people who are bedridden are among the groups of people most frequently affected by clubfoot. The malposition of the sickle foot that occurs as part of clubfoot is usually caused by a shortening of the Achilles tendon. The Latin term for this is pes equinus. This name has its origin in the fact that horses also walk only on their toes.

Hollow foot

A hollow foot is basically the opposite of a flat foot. The instep is considerably higher here and the foot appears compressed in its overall appearance. This makes it appear smaller than in the physiological position.

In addition to these misalignments, there is also an internal rotation of the soles of the feet, the so-called supination position. Due to this position, those affected walk on the outer edge of the foot.

How is a clubfoot treated?

If possible, treatment for congenital clubfoot should be started immediately after birth. The earlier treatment is started, the more likely it is that the foot will be in a normal position once treatment is complete.

If treatment is not started immediately, permanent deformities may occur which can only be treated by surgery.

When choosing the right treatment method, a distinction is made between congenital and acquired clubfoot.

Congenital clubfoot

In the case of congenital clubfoot, surgery is not necessarily indicated immediately. This is because the tissue of newborns and babies is still quite flexible and can be treated in other ways.

For example, it is possible to work with a plaster cast . This involves manually correcting the foot on the day of birth and plastering it in this corrected position. Manual correction is also known as redression treatment. The aim is to bring the feet back into the correct position.

Clubfoot treatment with a plaster cast for a newborn © SylwiaMoz | AdobeStock

As a rule, this method is not associated with pain for babies. The plaster cast is changed at increasingly long intervals to gradually correct the malposition. This is supported by professional physiotherapy and physiotherapy to mobilize the joints.

If redression treatment is carried out correctly and the plaster cast is correctly applied, conservative therapy is often promising.

To ensure success, however, a splint or special shoes must be worn at night after the cast treatment.

If conservative therapy does not bring the desired success, surgery is indicated. This often involves lengthening the Achilles tendon so that the pointed foot position can be corrected.

In addition, corrections to the bones or the ligamentous apparatus can also be carried out as part of foot surgery.

Acquired clubfoot

In the case of acquired clubfoot, on the other hand, conservative treatment methods rarely lead to the desired result. In individual cases, splints or special shoes can help if, for example, the nerves are the cause of the clubfoot.

The question of whether an operation is indicated depends not least on how far the clubfoot has already developed. The more severe it is, the sooner surgery should be performed.

However, surgery alone is not enough. Patients also often require long-term immobilization in a plaster splint to fix the surgically corrected position. Professional physiotherapy is used to work intensively on the muscles.

Postural corrections are also applied so that the clubfoot can be tackled.

What is the prognosis for clubfoot?

If a clubfoot is treated in good time and, if necessary, treated surgically, there is a good chance of eliminating these deformities, especially in infants.

However, the longer treatment is postponed - or if no treatment is carried out at all - the worse the patient's symptoms will become.