Clubfoot (Talipes Equinovarus)

If your child is born with a deformity, in this case a clubfoot, it is often a shock. A lot is suddenly coming your way. Immediately after birth, hospital visits begin and you hear one medical term after another. But what exactly is a clubfoot?

CLUBFOOT Talipes equinovarus

About 1 in 800 babies is born with a clubfoot. This congenital defect occurs twice as often in boys as in girls, a total of about 200 children per year. Boys are also more likely to have two club feet. The name given to the abnormality, clubfoot, is confusing, especially for people who do not know what it is about. They imagine a shapeless lump, while the foot is formed, but has a different position. The English term “clubfoot” seems to fit the deviation better, because the foot indeed resembles a (golf) club. This abnormality has various causes, such as positional abnormalities in the uterus or disruption of the nerve supply to the foot. Most of the time, however, the cause of clubfoot cannot be identified other than its hereditary component. When clubfoot is caused by a neurological condition, such as spina bifida, spasticity, connective tissue diseases, or too little amniotic fluid, the condition is usually worse and surgical correction is often required. Folic acid also plays an important role. Using this before and during pregnancy could prevent clubfoot.

The foot deformity consists of several parts:

  • The foot is tilted downwards: the equinus or pointed position.
  • The foot is tilted inward: the varus position.
  • The forefoot points inwards: the adduction position, which creates a comma shape.



The deformity already starts below the knee, the muscles and tendons are shorter and underdeveloped. The joint capsule, tendon capsule and ligaments in the foot may also be thickened. The Achilles tendon is often too short. Treatment should be started as soon as possible, often when the baby is 1 or 2 days old, but preferably within a week after birth. If you wait too long, valuable time is lost that cannot be made up. The first treatment consists of casting or taping the foot and leg. Parents are often very disappointed when they hear that their child cannot enjoy a nice bath because of this. During the first few weeks, the plaster is changed regularly, and new plaster is applied at least once or twice a week. The orthopedic surgeon continues to move the foot into the correct position.
It is important that a child feels comfortable during the treatments , for the treatment to be successful. For the success of the treatment, it is important that the child feels comfortable, so that it is relaxed and calm, so that the foot can then be placed in the correct position more easily. It is therefore preferable that the treatment takes place in a room specifically for children. This treatment is sufficient for approximately one third of children. For the remaining group, surgical intervention is necessary. This is determined by means of X-rays.
After the operation, a plaster cast will be needed for several weeks until the child can turn his foot up and to the side on his own. The foot is splinted until the age of 3 to 4 years; first day and night, but from the moment the child starts standing and walking, only sleeping, possibly in combination with adapted shoes for the day.

The future

All children with clubfeet keep their clubfoot for life. The condition cannot be cured. The aim of the treatment is to create a foot that is as normal as possible and that has as normal a function as possible at the end of the treatment. However, it always remains a foot that is slightly smaller than normal and the lower leg always remains a bit thinner, possibly also a bit shorter than normal. Most children, with appropriate treatment, will develop normally and be able to participate normally in sports and recreational activities.

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