Treatment is usually started as soon as the deformity is detected after birth. The goal of the treatment involves making the feet function and appear as normal as possible, without causing pain.
If treatment is started early, the chances of correcting the deformity are high. Usually conservative treatment is sufficient to correct club-foot with mild and flexible deformity. Physiotherapy alone can be effective in milder cases. In severe and rigid deformity, conservative treatment may fail and surgery is usually the next option.
Conservative treatment -
- The treatment most commonly consists of a series of plaster-castings in the newborn, over a period of several weeks with frequent cast changes to gradually correct the deformity (Ponsetti method). Ideally, the procedure is started just after birth when the foot is easiest to reshape. Longer delay means greater difficulty in correction.
- After the shape of the foot is realigned, it is maintained through exercise, night time splints and orthopedic shoes (a specialized boot designed for clubfoot deformity, which maintains the foot in its corrected position and prevents a relapse).
- A conservative treatment approach takes approximately 3 months, however maintaining the correct foot position may require use of braces and additional treatment for years.
- For those feet that do not respond to casting, surgery will be required once the child gets a little older (between 6 - 12 months). Hence, continued evaluation is recommended until the foot is fully grown.
Surgical Intervention-
- In children less than 5 years of age - soft tissue correction is done, and the shortened tendons and ligaments causing abnormal position of the foot are released.
- In children above 5 years of age - surgical correction - Bone re-shaping and Osteotomy (cutting & removing the bone) of the bones to correct abnormal foot position may be necessary.
