Clubfoot is a congenital birth defect also know as Congenital talipes eqinovarus. It affects one out of every 800 ~ 1,000 live births. Occurring twice as often in males than females. As many as 50% of these cases are bilateral, meaning both feet are affected.

There are four distinct components evident to some degree in most cases.

1.) Plantar flexion (equinus) of the ankle.
2.) High arch indicated by a crease across the sole of the foot.
3.) Abduction of the foot
4.) Abduction of the heel (hindfoot)

In addition to those characteristics the limb is shortened and the foot is much smaller. As much as 1 - 1½ shoes size in difference.. The affected foot is stiff, lacking normal motion. The calf muscle is noticeably smaller.

True clubfoot can be defined as a malformation with the bones, blood vessels, joints, muscles, and limbs being abnormal. A true clubfoot is a "manufacturing defect" so to speak. While a foot that appears to be clubbed is a "packaging defect" , a positional defect caused by the compression of the developing foot prior to birth. True idiopathic clubfoot does not usually respond to manipulation and casting alone.

Immediate diagnosis and treatment, within the first week of life, provides the best results with conservative methods. Casts are applied to the foot once it has been stretched into as normal a position as comfort allows. The sooner the better as the passage of time causes more resistance. Two to four months of casting is required, followed by additional splinting for the first year or two in most cases. Recurrence is possible within the first 2 - 7 years.

Casting has its complications. There can be increased cavus deformity, rocker bottom deformity, longitudinal breach, flattening of the proximal surface of the talus or lateral rotation of the ankle. Increased stiffness of the muscles and joints is also a possibility.

Surgery is a very common course of treatment that is, in most cases, successful in achieving a plantigrade, flat to the floor, position. The procedure ranges from heel cord lengthening to a complete medial, lateral, and posterior release of the foot. The surgeon can lengthen or release the contracted tendons allowing the stiff and misaligned joints of the foot to be positioned into normal alignment. Sometimes later in life there will be some pain in the foot necessitating modified footwear such as arch supports. The foot will remain smaller; not as noticeable in bilateral cases.

It is believed that a combination of several genes associated with other disorders(i.e. hip displaysia, spina bifida) play a role in this condition. However, at the present time there is no way to predict the genetics for clubfoot.