Talipes Equinovarus (TEV), commonly known as club foot, is one of the most common orthopedic birth defects. The incidence of club foot deformity is about 1 to 2 per 1000 live births. About 50 percent of cases are bilateral. The complex deformity is produced by tight ligaments and abnormal bones in the foot that cause the foot to be pointed downwards and turned inwards. This deformity does not correct on its own. Untreated TEV leads to weight bearing on the outside border of the foot which leads to significant disability in later life.
Club foot deformity can usually be identified on prenatal ultrasound exam. Some subtle cases may be missed on ultrasound but are easily diagnosed after birth. Once the condition has been detected, a targeted ultrasound will be performed to rule out the presence of associated anomalies. Amniocentesis maybe recommended to determine chromosomal abnormalities if club foot is not an isolated finding.
Early detection allows an opportunity for the treating physician to counsel patients about TEV and treatment modalities. Treatment success depends in part on parental education regarding the treatment process and common causes of recurrence. Since institution of early treatment is important, parents who are well versed with the diagnosis and treatment modalities make a smooth transition from delivery to start of therapy.
Most clubfoot deformities can be treated successfully with casting initiated during the first few weeks of life. The casting is performed weekly and allows gradual correction of the deformity. Most patients require a small surgery at the end of casting to release the Achilles tendon and allow completion of the deformity correction. Bracing is essential to maintain the correction obtained after casting. Initial bracing is around the clock but is decreased to night time wear by the time the child starts walking.
Most children respond to casting and Achilles tendon lengthening. Occasionally additional small surgeries may be required to restore muscle balance around the foot. Extensive surgical procedures may be required for persistent problems and recurrent club foot deformities that do not respond to casting.
Children successfully treated using casting and Achilles tendon releases have normal looking, flexible, pain free feet and can participate in all activities, including sports.
The Center team will help care for you and your infant with club foot. The Center will develop a comprehensive plan with all the physicians and specialists involved in the care of you and your newborn before, during, and after delivery.
When you contact The Fetal Center, you will be in touch with a dedicated coordinator who will walk you through the process step-by-step and help you to understand every aspect of your care.
The Fetal Center at Children's Memorial Hermann Hospital
UT Professional Building
6410 Fannin, Suite 210
Houston, Texas 77030
To contact The Fetal Center at Children's Memorial Hermann Hospital, please fill out the form below.
Located within the Texas Medical Center, The Fetal Center is affiliated with Children’s Memorial Hermann Hospital, McGovern Medical School at UTHealth, and UT Physicians.