Clubfoot repair


Definition

Clubfoot repair is surgery to correct a birth defect of the foot and ankle.

Alternative Names

Repair of clubfoot; Posteromedial release; Achilles tendon release; Clubfoot release; Talipes equinovarus - repair; Tibialis anterior tendon transfer

Description

The type of surgery that is done depends on:

Your child will have general anesthesia (asleep and pain-free) during the surgery.

Ligaments are tissues that help hold the bones together in the body. Tendons are tissues that help attach muscles to bones. A clubfoot occurs when tight tendons and ligaments prevent the foot from stretching into the right position.

To repair a clubfoot, 1 or 2 cuts are made in the skin, most often on the back of the foot and around the inside part of the foot.

Older children who still have a foot deformity after surgery may need more surgery. Also, children who have not had surgery yet may need surgery as they grow. Types of surgery they may need include:

Why the Procedure Is Performed

A baby who is born with a clubfoot is first treated with a cast to stretch the foot into a more normal position.

Clubfoot found in babies can often be successfully managed with casting and bracing, thereby avoiding surgery.

However, clubfoot repair surgery may be needed if:

Risks

Risks from any anesthesia and surgery are:

Possible problems from clubfoot surgery are:

Before the Procedure

Your child's health care provider may:

Always tell your child's provider:

During the days before the surgery:

On the day of the surgery:

After the Procedure

Depending on the surgery that is done, your child may go home on the same day or stay in the hospital for 1 to 3 days right after the surgery. The hospital stay may be longer if surgery was also done on the bones.

The child's foot should be kept in a raised position. Medicines may be prescribed to help control the pain.

The skin around your child's cast will be checked often to make sure it stays pink and healthy. Your child's toes also will be checked to make sure they are pink and your child can move and feel them. These are signs of proper blood flow.

Your child will have a cast on for 6 to 12 weeks. It may be changed several times. Before your child leaves the hospital, you will be taught how to take care of the cast.

When the last cast is taken off, your child will probably be prescribed a brace, and may be referred for physical therapy. The therapist will teach you exercises to do with your child to strengthen the foot and make sure it stays flexible.

Outlook (Prognosis)

After recovering from surgery, your child's foot will be in a much better position. Your child should be able to have a normal, active life, including playing sports. But the foot may be stiffer than a foot that has not been treated with surgery.

In most cases of clubfoot, if only one side is affected, the child's foot and calf will be smaller than normal for the rest of the child's life.

Children who have had clubfoot surgery may need another surgery later in life.

References

Herring JA. Orthopaedic-related syndromes. In: Herring JA, ed. Tachdjian's Pediatric Orthopaedics. 6th ed. Philadelphia, PA: Elsevier; 2022:chap 37.

Kelly DM. Congenital anomalies of the lower extremity. In: Azar FM, Beaty JH, eds. Campbell's Operative Orthopaedics. 14th ed. Philadelphia, PA: Elsevier; 2021:chap 29.

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