Club foot or clubfoot, also called congenital talipes equinovarus (CTEV), is a congenital deformity involving one foot or both.The affected foot appears to have been rotated internally at the ankle. Without treatment, people with club feet often appear to walk on their ankles or on the sides of their feet. However with treatment, the vast majority of patients recover completely during early childhood and are able to walk and participate in athletics as well as patients born without CTEV.

It is a relatively common birth defect, occurring in about one in every 1,000 live births. Approximately half of people with clubfoot have it affect both feet, which is called bilateral club foot. In most cases it is an isolated disorder of the limbs and occurs in males twice as frequently as in females.

A condition of the same name appears in some non-human animals, particularly horses. Clubfoot is usually diagnosed immediately after birth simply by looking at the foot.It is then up to the doctor whether or not to x-ray the foot or feet to examine how the internal structures are positioned. In some cases and may be possible to detect the disease prior to birth during the ultrasound. It may be more prominent if both feet are affected. The ability to possibly identify clubfoot before live birth can prove beneficial to the child as different treatments can be explored.

Various types of foot-abduction braces are used to hold the child’s feet in the desired position.

Once a child has been diagnosed with clubfoot, there are many different treatment approaches. Treatment should be given immediately after diagnosis to take full advantage of the flexibility in the baby’s bones and joints. This allows for improved manipulation to try to achieve a normal foot. The Ponseti method appears to result in better outcomes than the Kite method and similar outcomes to a traditional technique.

This involves manipulation by people specialized in the technique with serial casting and then providing braces to hold the feet in a plantigrade position. After serial casting, a foot abduction brace such as a Denis Browne bar with straight lace boots, ankle foot orthoses and/or custom foot orthoses (CFO) may be used. Foot manipulations usually begin within two weeks of birth.

For more information about disability, please contact Petra Burger ( HPCA Disability Project Coordinator) – petra@hpca.co.za