Fetal clubfoot, also known as talipes equinovarus, is a congenital (present at birth) foot deformity in which the foot is curved toward the middle of the body and the toes point downward. It affects the bones, muscles, tendons and blood vessels (of the limb) and can affect one or both feet. The foot is usually short and broad in appearance, and the heel points downward while the front half of the foot, or forefoot, turns inward. The heel can appear narrow and the muscles in the calf are smaller compared to a normal lower leg. Despite its appearance and its name, the affected foot and leg contain all the same bones, muscles, tendons, and anatomic parts as the unaffected limb — only they are misshapen until corrected.
Clubfoot occurs in approximately one in every 1,000 live births and occurs in males twice as often as females. One in every two cases affects both feet.
Fetal clubfoot can be diagnosed by ultrasound (sonogram) examination prior to birth. Consultations are available in the Institute for Fetal Health.
Approximately 10% of all clubfeet can be diagnosed by 13 weeks gestation, and about 80% can be diagnosed by 24 weeks gestation. However, diagnosis based on ultrasound alone produces a 20% false positive rate. This is because the normally shaped foot sometimes turns inwards momentarily as the baby wiggles his toes and feet, and if an ultrasound picture is made at that instant the foot appears deformed.
After a fetus is diagnosed with clubfoot, the orthopedic specialists and nurses counsel parents about what to expect when their baby is born and reassure them that the condition is correctable after birth. Parents also meet with the physical therapist before their baby is born to discuss how the stretching and casting is done. Parents are asked to bring their infants for evaluation as early as early as the first few weeks after birth.