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Plymouth Paediatric Orthopaedics

Club Foot

Clubfoot (CF) or talipes equino varus, is a complex congenital deformity of children’s feet. It is usually diagnosed at birth, but may be diagnosed on ante-natal scans. It occurs in 1 in 1000 births, is bilateral in half and affects boys and girls equally.

Treatment involves serial plaster casts being applied to gently reshape the foot. This technique described by Ignacio Ponseti has dramatically reduced the requirement for complex surgical procedures.

Casting starts as soon as possible after birth, and is directed by our expert team of physiotherapists. The severity of the deformity and ease of correction usually determines the number of casts required. These are changed on a weekly basis as the foot is gradually corrected. The first few casts actually make the foot look worse, but are an important part of the treatment. Usually 5-6 weeks of casting is required.

If a full correction is not achieved with casting, a small operation called an Achilles tenotomy is indicated.

After casting, children are placed in boots and bars to maintain the correction. This is initially all day for the first 2-3 months, progressing to only at night until the age of 4. This significantly reduces the risk of recurrence, which can be more difficult to treat.

Very rarely is casting unsuccessful to the point that an open operative release of the foot is required.

Affected feet will always be smaller than the unaffected side, but should not prevent active participation in most sports. There are Olympic medalists who have had clubfeet, so nothing is impossible!

Ponseti.info