The Importance of Early Diagnosis and Treatment in Clubfoot

By Dr. Sujith Omkaram, Consultant Paediatric Orthopaedician Ankura Hospital for Women and Children

Clubfoot, or congenital talipes equinovarus (CTEV), is a common deformity affecting approximately 1-2 in every 1,000 live births. If left untreated, it can lead to significant physical disability and lifelong challenges. Effective management of clubfoot relies on early diagnosis and treatment, which can dramatically improve outcomes for affected children.

Antenatal diagnosis of clubfoot is possible through ultrasound scans during the second trimester of pregnancy. Informing expecting parents about the condition and its treatment can alleviate anxiety and ensure adherence to treatment protocols. The Ponseti method, the gold standard in treating clubfoot, involves weekly changes of casts. Most cases can be completely corrected with 4 to 6 casts, typically by the time the baby is 1 to 2 months old, thus avoiding surgical intervention. Early onset of cast treatment and subsequent foot abduction bracing until the age of 4-5 years are crucial for successful correction.

Initiating treatment during the newborn period enhances the likelihood of successful correction, as tissues in newborns’ feet are more malleable and responsive to corrective measures. Ideally, treatment should begin within the first week after birth. Even cases presenting after a year can be treated successfully with Ponseti casts, though the likelihood of needing surgical intervention increases with age. Untreated clubfoot can result in chronic pain, difficulty walking, and the development of calluses or sores due to abnormal pressure points on the feet.

Early treatment increases the chances of developing normal or near-normal feet, leading to improved mobility and better participation in physical activities. This ensures that children can engage in activities appropriate for their age without significant physical limitations. Additionally, early intervention reduces the need for extensive and expensive treatments later in life, minimizing healthcare costs and the economic burden on families.

In conclusion, early diagnosis and treatment of clubfoot transform the lives of affected children by enabling normal foot development and an enhanced quality of life. This approach not only supports families in managing the condition confidently and effectively but also ensures that children can lead active, healthy lives free from the limitations imposed by untreated clubfoot.