Child Clubfoot

Below is an illustration of the foot of a child with congenital clubfoot comparing the boney structure to the clinical apperance with the inward devation of the heel bone and forefoot creating a c-shaped foot.



  • Congenital clubfoot is a structural foot deformity that is present at birth
  • There is in utero malalignment of the talocalcaneal, talonavicular and calcaneocuboid joints
  • Articular malalignments are fixed by contracted joint capsules, ligaments, and contracted foot and ankle tendons.
  • May be bilateral in up to 50%
  • Occurs in about 1 out of 800 births
  • More common in males than females
  • Pathanotomy
  • Genetic tendency
  • If both parents are normal with affected child, risk of next child having clubfoot is 2-5%
  • With one affected parent and one affected child, then risk of next child having clubfoot is about 10-25%
  • In some syndromes such as diastrophic dwarfism, there is autosomal recessive inheritance

Different diagnosis:

  • Muscular dystrophy
  • Myelomeningocele
  • Polio
  • Peroneal type of progressive muscle atrophy
  • Cerebral Palsy

Treatment options:

  • Clubfoot casting

Surgical options:

  • Circumferential release "Cincinnati Incision
  • Medial Release
  • Posterior Release
  • Posteromedial release
  • Tendon transfers

Salvage procedures:

  • Combined soft tissue and bone procedures
  • Arthrodesis / osteotomy
  • Triple arthrodesis

Forefoot adduction deformity:

  • Surgery is advocated in children older than age 4, or when the medial cuneiform ossific nucleus is well developed
  • Talectomy

Pics Below of Serial Casting for a Cavovarus foot that is reducible in a 5 week old.