​What kinds of symptoms do patients experience before receiving treatment?

Clubfoot is a common congenital disorder of the lower limbs. It occurs when a foot and ankle are permanently twisted. The ligaments and tendons that hold the muscles to the bones are too tight, which causes the tissues around the ankle to hold the foot in an abnormal position. A clubfoot appears to be pointing downward and twisting inward. For an adult with an uncorrected clubfoot, only part of the foot touches the ground. Walking is difficult or impossible.

​What is the impact on patients’ lives of living with these conditions?

Neglected clubfoot has a long-term impact on a person's quality of life. Children from rural areas or low socioeconomic backgrounds lack access to adequate care or information. These children may face a life of disability due to untreated clubfoot.

What cultural or regional factors affect the treatment of these conditions?

There is no historical, cultural, or regional significance to this condition or its treatment. Much of the abnormality can be corrected through manipulation and casting during the first three months of life. This treatment is not risky, but access to long-term orthopedic care is required to ensure that the correction is maintained. Exercises, corrective shoes, or nighttime splints may be needed until the child stops growing.

What does the treatment process look like?

The orthopedic surgeon will first try to correct the clubfoot using nonsurgical methods. The patient's foot is gently stretched and manipulated into the correct position and held in place with a long-leg cast that stretches from the toes to the thigh. Each week for six to eight weeks, this process of stretching, re-positioning, and casting is repeated. After the manipulation and casting period, an Achilles tenotomy is performed. This is a minor procedure to release tightness in the Achilles tendon. A new cast will be applied to the leg to protect the tendon as it heals. By the time the cast is removed, the Achilles tendon will have regrown to a proper, longer length, and the clubfoot will be fully corrected. Many cases of clubfoot are successfully corrected with nonsurgical methods. Sometimes, however, the abnormality cannot be fully corrected, or it returns. Surgery may be needed to adjust the tendons, ligaments, and joints in the foot and ankle.

What is the impact of this treatment on the patient’s life?

Quality of life is improved. Most individuals are able to wear regular shoes and lead active lives.

What potential side effects or risks come with this treatment?

Children who undergo clubfoot repair surgery can lead active lives with few risks. In some cases, the foot and calf may remain smaller throughout the patient's life. Potential risks associated with this surgery also include nerve damage in the foot, excessive foot swelling, interrupted blood flow to the foot, and the formation of an ulcer from a cast that is too tight.

How accessible is treatment in the area? What is the typical journey like for a patient to receive care?

This treatment is available in most tertiary hospitals. It is performed by experienced orthopedic surgeons who are specialists in the field.

What are the alternatives to this treatment?

There is no alternative treatment for this condition.