Club foot 

Vanessa and Jon's daughter was born with club feet. They describe coping with the diagnosis and choosing her treatment, and an expert compares physiotherapy with surgery.

Learn about treatment for club foot

Transcript of Club foot

Clubfoot is one of the most common foot problems babies can be born with.

Approximately one in a thousand in the UK are born with clubfoot.

Clubfoot's also known as talipes.

I think the historical vision of clubfoot is something of the past.

No longer do we think about children in callipers or with limps.

In the past, children treated with surgery to correct their clubfoot

could be left with stiff, painful feet that severely limited their activity.

We were diagnosed in a 22-week scan

and we thought she was facing years of surgery

and scar tissue and arthritis and everything,

and it just hasn't been like that at all.

This is a skeleton model of a clubfoot.

And you can see that the foot is turned in and around,

and also, at the back of the foot, the heel is lifted up and high,

held there by very tight tendons at the back of the foot

and tight tendons on the inside here.

The foot is also short and it's also rather wide in shape.

The birth was great because we knew about the talipes

and were expecting them.

And it was a planned caesarean for her.

So when she came out with wonky feet,

we were expecting them, so it was no shock.

The good news for families whose baby is diagnosed with clubfoot

is that the Ponseti Method offers a simple and straightforward method

of correcting clubfoot which involves minimal surgical intervention.

In an ideal world, the baby would begin treatment at about two weeks of age.

Ponseti Method involves a careful assessment of the foot

followed by manipulation of the foot.

And this is a very gentle movement through the available range.

(father) I think it's about 130 degrees that they have to rotate it.

They rotate the foot to a position that's not uncomfortable for the child,

but which is challenging the tendons and things.

And so the child's not in any kind of pain.

And then they simply cast with the foot in that position.

(Denise Watson) The final thing is to release the tight Achilles tendon,

which lets the heel drop down into position,

and this can usually be done under local anaesthetic.

The foot then goes into a final cast which will stay on for three weeks

while the site heals.

Usually babies take approximately six casts to get a corrected foot position.

I remember a parent at the time saying, "Oh, this stage goes so quickly.

"You'll look back and it will have gone in a flash."

But at the time it's really real and you think, "How can it possibly go quickly?"

But then it's six weeks and it's nothing.

And then you're on to the bar and boot stage.

(Denise Watson) Boots and bar are a vital part of the treatment

and hold the foot in corrected position

and allow the bones to remodel.

The boots and bar are worn 23 hours a day

for three months after correction

and then at nighttimes and naps

until the child is five years of age.

(mother) It's almost like starting a countdown.

You've got this hour out

to bathe her and play with her and give her a kick-about

and then put her back into the boots.

(father) She never complained that they went back on.

No, she didn't.

It's an advantage of treatment starting so young. She learnt to crawl early.

She would learn to roll over first and then flick her legs round,

and she just learnt to do that.

She wasn't slowed down by them.

In fact I think she crawled at about the right time, which was nine months.

And she started walking, I think, at 13 or 14 months.

So pretty much the same as any other child.

(Denise Watson) It is a simple treatment,

but it does rely on the clinician being very precise about their technique.

It also relies on positive input from the family

and commitment to see the process through.

(mother) When we were first told,

you have these terrible thoughts going through your mind,

but she's just like any other normal two-year-old running around.

And It's just amazing. Takes your breath away, doesn't it, really?

(father) To us it was tragic, but you know,

it's not so bad, and the treatment now is so good

that we count our lucky stars, really, that that's all she had.


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