Scottish Rite for Children is one of the world’s leading treatment centers for children and adolescents with a variety of congenital and acquired foot deformities. Through the Center for Excellence in Foot, our multidisciplinary team is dedicated to providing world-renowned and individualized patient care while advancing treatment techniques through research.
 
Clubfoot is one of the most common pediatric orthopedic conditions. The center treats more than 1,000 patients with the condition each year. The team includes staff from orthopedics, bioengineering, movement science, molecular genetics, orthotics and physical therapy who collaborate to conduct extensive research into clubfoot – its cause, efficacy of treatment options and further understanding of related deformities.
 
What is clubfoot?
Clubfoot is a term used to describe a foot abnormality that is present at birth. In this condition, the foot is turned inward and pointed downward.
 
What causes clubfoot?

• The exact cause is unknown.
• It is more common in males than females and affects about one in every 1,000 births. 

What treatment options are available?
Treatment options are different for every child. After a thorough physical exam, a pediatric orthopedic specialist may recommend one or more of the following treatment options.
 
Observation
In some cases where the foot abnormality is mild and due to positioning of the baby in the uterus, the position of the foot may improve without treatment. In this case, the specialist will evaluate the foot periodically to make sure no additional treatment is needed.
 
Casting/Stretching
The most common form of treatment for clubfoot is serial casting/stretching. The goal of this treatment is to keep the foot/feet in the proper position for extended periods to allow the muscles to stretch and the development of the bones and other tissue to occur normally.
This can be accomplished in several ways:
 
Ponseti Casting Method

• Placing a cast from the thigh to the toes after gentle stretching of the foot. Each week for 4-6 weeks, a new plaster cast is put on the child to help the foot stretch further and continue gradual improvement in positioning.
• The majority of children treated with serial casting will require a procedure to lengthen their Achilles tendon (heel cord). This is most often done in the clinic setting with local anesthetic for pain control.
• Upon the completion of serial casting, bracing for a period of time is recommended to help maintain the corrected position of the foot and prevent recurrence. 

French Functional Method – Physical Therapy

• Daily stretching, mobilization and taping to slowly move the foot to the correct position.
• The child is in the care of a trained physical therapist during these sessions.

Surgery
In some cases, surgery may be required to correct the position of the foot/feet when non-surgical treatment options are not successful, although the majority of children with clubfeet can be treated by non-surgical methods.
 
Learn more about the care & treatment of clubfoot.