Clubfoot

Most children born with clubfoot have a congenital (present at birth) abnormality that causes one or both feet to turn inward and downward. For the majority of children, clubfoot is almost completely correctable without major surgery or pain. Nemours orthopedic specialists use an established method to gently and safely stretch your child’s foot or feet into the correct forward-facing position using casts and, later, orthotics (braces).

 
Learn More About Congenital Clubfoot

Congenital clubfoot occurs in about one out of 1,000 children and is twice as common in boys as girls. For kids diagnosed with the condition, there’s an excellent chance that proper treatment will allow them to run, jump, play sports, dance, and experience all the joys of childhood.

The most effective and least expensive treatment for congenital clubfoot is the Ponseti method. Named after Ignacio Ponseti, the doctor who invented it, this minimally invasive treatment is considered the international gold standard in correcting clubfoot. It starts shortly after birth and has two distinct phases:

  • Casting: A cast is placed on the affected foot or feet to gently guide the bones, ligaments, and tendons toward the correct position. The cast is replaced and adjusted weekly for several weeks. Many children do require a minor procedure to help achieve the final corrected position of the foot.
  • Orthotics: After the final cast, they’ll be fitted for an orthotic, which keeps the clubfoot from developing again. The orthotic is used for a period of 2 to 5 years, mostly at night.

The Ponseti method has been developed and refined over the past 50 years, and numerous studies have shown that it’s almost always the most effective and least painful way to correct a clubfoot. It doesn’t cure clubfoot entirely, and the affected feet and calf muscles are usually a little smaller than normal. But the method does restore your child’s ability to enjoy all the physical activities of a normal childhood.

Nemours Children's Clinic, Jacksonville

807 Children’s Way
Jacksonville, FL 32207
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For Appointments: (904) 697-3600

Hours: Monday–Friday, 8 a.m. to 5 p.m.
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What to Bring
  • your photo ID
  • insurance and/or Medicaid cards
  • referral from your referring physician (if required by your insurance)
  • co-payment, if applicable
  • legal guardianship or custody papers if you are not the patient’s parent
If available, please provide:
  • preferred pharmacy contact information
  • names and dosages of all medications your child is taking (including over-the-counter medications)
  • name and number of your primary care physician
  • parent (and child’s) social security numbers
  • parent work information (address, telephone numbers)
  • immigration information (if your child was not born in the United States)
  • list of prior immunizations
New Patients

Bring these forms for your first appointment:

Returning Patients
 
Forms & Resources
New Patient Forms
Returning Patient Forms
  • Patient Presents without Legal Guardian (PDF)
    English | Español
    Note: A parent or legal guardian must be with a child for a first visit.
Resources for Patients & Families

The orthopedic specialists at Nemours Children’s Clinic, Jacksonville, are experts at diagnosing and treating children born with congenital and other forms of clubfoot. If your child has clubfoot, it will be detectable in a standard prenatal ultrasound or will be visible immediately at birth. We recommend contacting us as soon as the diagnosis is made.

 
What To Expect At Your First Visit

At Nemours Children’s Clinic, Jacksonville, the orthopedic physician who treats children with clubfoot is approved by the Ponseti Institute. This distinction is your assurance that your child’s care will comply with the Ponseti method, the most widely accepted treatment regimen for clubfoot. Your first visit will include a careful examination to determine if your child has any other medical factors. We may need an ultrasound or x-ray (both available at our clinic) or CT scan, MRI scan, or other imaging procedure, available through our nearby partner, Wolfson Children’s Hospital.

Most children with clubfoot do not have complications, and the condition is treated on its own, nearly always using a minimally invasive procedure that corrects the malformation gently over time and without significant pain.

For a small number of children, clubfoot can occur with other conditions, including:

If this is the case, your Nemours physician will work with other specialists at the clinic and hospital to coordinate treatment for all conditions in a way that gives your child the best chance for an active, healthy childhood.

 
Gentle Stretching Through Casts and Braces

Starting within weeks after birth and using techniques refined over decades, your Nemours specialist will begin easing your child’s foot gently into the correct position with a cast that may extend partially up the leg. The casting process, repeated approximately every week, is nearly painless and usually takes less than 30 minutes. This regimen usually lasts between 4 and 9 weeks; the final cast may remain in place for up to 3 weeks. You’ll learn about bathing and caring for your child during this period.

Following the casting period, your child will be fitted for an orthotic (brace), which continues the gentle stretching process. You’ll receive detailed instructions on how and when to use the brace. To make the most of your child’s chance for successful treatment, it’s important to follow these instructions exactly as presented, without modifying or adapting them. Always call with any questions before making any adjustments.

At first, the brace stays on almost constantly and is removed only for bathing. After a few months, before your child starts crawling or walking, the brace is worn only at night. There are no restrictions on normal activities. Bracing may continue for up to 5 years.

The brace for your child may be provided at our clinic, or you may receive a prescription and help from our staff connecting with a provider that can supply it to you.

 
Follow Up Procedures

In some cases, the gentle stretching that’s a hallmark of the Ponseti method may leave your child with an Achilles tendon that’s a little too tight. To correct this, your Nemours physician may need to make a small incision in the back of the foot to help the tendon grow correctly. This nearly painless procedure might take place in the office or in the Operating Room at the hospital and will heal in a few weeks.

Some children between the ages of 3 and 5 might experience a partial relapse of clubfoot. If this is the case, your Nemours physician may need to:

  • do additional casting to re-correct the position of the foot
  • perform a procedure to transfer the anterior tibialis tendon to the middle of the foot
  • lengthen the Achilles tendon

Your child may also be referred to a Physical Therapist for exercises that can help strengthen the muscles in the calf and foot and relieve any minor discomfort as your child grows.

 
Genetic Considerations Help You Make Informed Decisions

One in 1,000 children is born with congenital clubfoot. That possibility increases if the condition is present in your family’s history. Clubfoot occurs about twice as often in boys as girls. If you have one child with clubfoot, there’s a greater chance that the condition will occur in

  • additional children with the same parents
  • children born to your child with clubfoot
  • children born to your child’s siblings

Because genetics plays a role in determining who is born with clubfoot, your Nemours physician may also suggest a visit with a geneticist, who can provide guidance on the chances that you or your children will have children with the same condition.