Treating Clubfoot

It is the most common congenital birth defect you probably know nothing about, affecting one in 500 babies.

Comedian Damon Wayans, quarterback Troy Aikman and Olympic figure skater Kristi Yamaguchi all share this condition, and baby Kilian Ferner does too.

It is known as clubfoot.

Clubfoot is a common birth defect that affects boys twice as often as girls. The disease is one that Ferner’s mother did not know.

"I thought the word clubfoot was really scary and I thought it meant they had this foot that didn't work, and it followed behind them and they dragged it with them wherever they went," said Erin Ferner.

With clubfoot, one or both feet are twisted inward. Kilian Ferner had it in both.

"It's a lot of fear and it's a lot of you know, will he be okay?" his mother said.

But with advances in treatment, Dr. John Herzenberg says it is nothing to cause fear.

"Yes, your child will be able to grow up and play sports and do just about anything he wants," said Herzenberg, director of pediatric orthopedics at the Sinai Hospital of Baltimore.

The best treatment option is the Ponseti Method, which uses a series of casts over several months to straighten the foot.

"It's kind of like braces on your teeth where you move it slowly, little by little, about ten degrees every week until the foot is twisted out,” said Herzenberg.

You can see the difference after six months.

Ferner had seven casts in all, each of them telling a story.

"Each week there was a different quote about how we overcame, you know, whatever we had to cross that week,” said his mother.

From the first one…

"If you can find a path with no obstacles, it probably doesn't lead anywhere,” read Ferner’s mom.

…to the last.

“This one, fingers crossed, is my last one,” she said. “’This makes my mommy happy because she can,' sorry I'm going to cry, ‘because she can't wait to hold and kiss my little feet.'"

Now, little Kilian can follow along in his big brother’s footsteps when he is ready.

Dr. Herzenberg says that Ferner had true clubfoot on one foot and positional foot on the other. Treatment for a positional clubfoot is much less difficult than a true clubfoot.

He says that once they are out of the casts, babies with clubfoot must then wear special shoes for three months to keep their feet in the right place. After that, they can wear them just at night until age four.

The Ponseti Method was once only used for newborn babies. Now it is also being used in developing countries to help older children with clubfoot return to normal.

REPORT #2021

BACKGROUND: Clubfoot describes a range of foot abnormalities that is usually present at birth in which a baby's foot is twisted out of shape or position. In clubfoot, the tissues that connect muscles to the bone (tendons) are shorter than usual. The term "clubfoot" refers to the way the foot is positioned at a sharp angle to the ankle, similar to the head of a gulf club. It can be mild or severe. About half of children with clubfoot have it in both feet. If a child has clubfoot, walking normally will be difficult. So, doctors recommend treating it soon after birth. (Source:

SYMPTOMS: If a baby has clubfoot, his or her foot may have the following appearance:
* The foot may be turned so severely that it actually looks as if it's upside down.
* The calf muscles are usually underdeveloped.
* The top of the foot is usually twisted downward and inward, increasing the arch and turning the heel inward.
* The affected foot may be up to half an inch shorter than the other foot. (Source:

TREATMENTS: Stretching and casting, Ponseti Method, is the most common treatment for clubfoot. The doctor will move the baby's foot into a correct position and then place it in a cast to hold it in that position. Then, the doctor will reposition and recast the baby's foot once or twice a week for several months. Towards the end of this process, the doctor will perform a minor surgical procedure to lengthen the Achilles tendon. After the shape of the foot is realigned, parents will need to maintain it by doing stretches with their baby, putting them in special shoes and braces, and making sure they wear them as long as needed (usually three months at the most). Another approach is called the functional method or the physiotherapy method, which consists of stretching and taping. For this method parents work with physical therapist. First, they move the foot daily and hold it in position with adhesive tape. When the baby is asleep, a machine continuously moves the baby's foot. After two months, treatment is cut back to three times a week until the baby is six months old. Once the shape is corrected, parents still perform daily exercises and use night splints until the baby is old enough to walk. This method requires a much greater time commitment than the Ponseti Method. (Source:

? For More Information, Contact:

Lee Brady, RN
Education Nurse Specialist
Sinai Hospital of Baltimore

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