Club foot or the medical nomenclature name “pes equino-varus” is a relatively common foot anomaly seen after birth. Although the incidence differs according t race and geography, it is roughly seen once in 1,000 birth. Unfortunately, it may cause lifelong disability if left untreated or mistreated. There is no defined underlying etiology for the development of this foot anomaly.
Club foot may be seen in single or both foot. If it is single, right foot is the commonly seen one. The foot deformity is mostly the single problem in the body. However, it may be an associated part of a syndrome and in that case the deformity is usually more aggressive and more resistant to treatment.
Club foot occurs during prenatal period. It may be possible to detect the deformity during pregnancy, however there is no intra-uterine treatment. Early diagnosis and treatment is vital for the fate of the foot. The treatment should begin within the first week of birth and serial casting is done with 10 day intervals. The casting is done according to Ponseti method which is a world wide accepted treatment. The aim of casting is gradually bringing to foot to its neutral position by stretching. Although varies, casting usually continues for 2 months. A small percutaneous Achilles tenotomy may be required in some cases. After completion of casting, the foot is put in a specially designed orthosis.
The club foot patient must be followed for long time because relapses are common after the treatment. If recurrence is observed, surgical correction may be required. The surgical options varied from osteotomies to tendon transfers and soft tissue releases.