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Clubfoot

When a baby's foot points in and down

Clubfoot is also called talipes equinovarus. It means the foot points inward and downward at birth.

It can affect one foot or both feet. Doctors call it isolated clubfoot when no other problem is seen. The clubfoot is the only finding on the scan.

Most babies do well after treatment.

Sometimes the foot looks turned because of how the baby is lying. Your doctor may repeat the scan.

Patient-friendly medical illustration comparing a normal newborn foot with a clubfoot and showing early treatment with a cast and boots-and-bar brace.
After birth, care often uses gentle stretching, casts, and boots and bar.
Most clubfeet get much better with treatment. Care often starts soon after birth. Many children later walk, run, and play.

Why can this happen?

Doctors often do not know one exact cause.

Most of the time, clubfoot happens by itself.

Genes may play a part. Genes are tiny instructions in the body. They help tell the body how to grow.

A chromosome condition may also play a part. Chromosomes are bundles that carry genes.

It can also happen with problems in the spine, brain, muscles, or joints.

What tests are needed?

  • A detailed ultrasound checks the feet and the rest of the baby.
  • The scan also looks closely at the spine, brain, and heart.
  • You may meet a genetic counselor. This person explains genes and tests.
  • Your doctor should offer diagnostic testing. This means testing that can give a more certain answer. One option is amniocentesis. A small amount of fluid is taken from around the baby.
  • A chromosome microarray may be done on the sample. This test looks for small missing or extra pieces of chromosomes.
  • Fetal MRI or a fetal echocardiogram (a detailed heart ultrasound) may be used if doctors worry about another problem.

What does this mean for pregnancy?

If no other problem is seen, the outlook is very good.

There is no treatment needed during pregnancy for isolated clubfoot. Treatment starts after birth.

Birth plans usually do not need to change.

You may meet the children's foot doctor before birth to learn what treatment will be like.

If other problems are found, they may change the baby's care.

What happens after birth?

Your baby should see a pediatric orthopedic surgeon after birth. This doctor treats children's bones and feet.

The main treatment is the Ponseti method. It uses gentle stretching, casts, and a brace.

  • Care usually starts in the first 1 to 3 weeks after birth.
  • Most babies need about 5 to 8 weekly casts.
  • About 9 out of 10 babies need an Achilles tenotomy. This is a small cut that loosens the tight heel cord.
  • A final cast is usually worn for about 3 weeks.

What should parents expect next?

  • After the casts, babies wear a boots-and-bar brace.
  • The brace is often worn about 23 hours a day for 3 months.
  • Then it is worn at night and nap time, often 12 to 14 hours a day, until about age 4 to 5 years.
  • Your child's foot doctor will tell you when it is safe to stop the brace.
  • Using the brace as told is very important. Clubfoot can come back.
  • Some children need more casts or surgery later.

What can I expect later?

Most children have a foot that works well and does not hurt after care.

The calf may stay a little smaller. The foot may also stay a little shorter.

Many children can wear regular shoes and walk, run, and play.

Important: A foot can sometimes look turned before birth. Your doctor may repeat the scan and check the rest of the baby.
Medical references and guidance
  1. Society for Maternal-Fetal Medicine. Fetal Anomalies Consult Series #2: Extremities, including congenital talipes equinovarus (clubfoot). 2019.
  2. American Academy of Orthopaedic Surgeons (OrthoInfo). Clubfoot.
  3. Centers for Disease Control and Prevention. Talipes equinovarus (clubfoot) overview.