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Clubfoot repair

Definition

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

See: Clubfoot

Alternative Names

Description

The type and extent of surgery depends on the severity of the problem. Persons with a clubfoot have tight tendons and ligaments in the foot and ankle.

The surgery involves lengthening some tendons and releasing tight ligaments so that bones and joints can be placed into normal positions. Sometimes, pins are temporarily placed in the foot and a cast is placed on the affected foot after surgery to keep it in position while it heals.

Why the Procedure is Performed

Clubfoot repair surgery is considered if other treatments do not adequately correct the condition, if the condition returns, or if it is associated with disorders of the muscles or nerves.

The newborn's clubfoot is first treated with casts. The tendons, ligaments, and bones are still quite flexible in a newborn and are somewhat easy to reposition. The foot is stretched into a more normal position and a lightweight cast is applied to retain the corrected position. The cast will be placed every week so the foot can be further stretched into better position. This series of casting is continued for approximately 2 months, and is successful in at least 50 - 95% of cases.

Risks

Risks for anesthesia include the following:

• Breathing problems
• Reactions to medications

Risks for surgery include the following:

• Bleeding
• Infection

Possible complications related to the surgery itself include:

• Foot swelling
• Infection
• Problems with blood flow to the foot

Outlook (Prognosis)

The surgically corrected foot is generally very functional, although typically somewhat stiffer than a normal foot or one treated without surgery. In most cases, the child's foot and calf may remain smaller than normal throughout life.

Physical therapy may help keep the foot in good position and help improve function and flexibility. Bracing after surgery is frequently necessary.

Recovery

The child will stay in the hospital for approximately 1 - 3 days after surgery. The foot will be kept in a raised position. Medications may be used for pain. The skin around the cast and the toes will be checked frequently to make sure that there is proper blood flow.

Before leaving the hospital, the parent will be taught how to take care of the cast.

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