What is a club-foot ?

Embryology
The development of the foot during the intra-uterine (morphogenenesis) growth is very premature: during the 2nd month of life.
Antenatal diagnosis At present 46 % of club feet varus équin are diagnosed in ante-native echography
Definition

The malformed foot, called also club-foot, is an abnormality of development of the foot arising during the foetal period.
It is about a congenital deformation (that is existing from the birth).

Frequency
This abnormality gets(touches) 1 to 2 child (ren) for 1000 births.
 
Sex
The boys are more touched than the girls (70 % of the cases).
Sexe ratio

Side


Two feet are touched in half of the cases.
Explanations

The bones of the foot, their joints and the mild parts (tendons, muscles, skin, capsules of the joints) are deformed in several plans of the space.
These deformations are visible from the birth.
The foot and the ankle miss flexibility and seem stiffed in bad position.

Genetic aspects of the club-foot In certain families and populations, the arisen of malformed foot varus équin idiopathique is more frequent.

The research for facilitating genetic factors was already the object of several publications.


See the page
Genetics of the club-foot
(under development)
Club-foot idiopathic
and
secondary club-foot

The term of club-foot idiopathic means that there does not exist other disease being able to take part in the deformation of the foot.
A secondary club-foot appears in a context of more general disease of the body: neurological disease, disease concerning the flexibility of all fabrics.
The club-foot secondaries are often very difficult to look after.

 
Diagnosis
(club-foot idiopathic)

To make the diagnosis of club-foot to the birth, it is necessary to note a deformation and a stiffness of the foot in several plan of space:


 
   

adduction of the before-foot
varus of the back-foot
supination du pied
equine of the foot and of ankle
cavus of the foot

   
adduction of the before-foot
by looking at the foot by the lower part, one sees that the part before foot (with the toes) turns inside
(Glossary)
    varus of the back-foot
by looking at the foot by behind, one sees that the heel rocks inside
(Glossary)
    supination of the foot
by looking at the foot per front, one sees that the plant of the foot is turned upwards
(Glossary)
  equine of the foot and of ankle
by looking at the foot of profile, one sees that the point of the foot is directed downwards
(Glossary)
    cavus of the foot
the cavus is the aspect of break of the foot, definitely visible with the level of the medium of the foot, on its internal edge
(Glossary)
Diagnostics différentiels et autres anomalies des pieds à la naissance  

The foot varus

It is about a malposition of the foot which resembles much the club-foot varus equine, to the difference that this bad position is reducible during the passive mobilization of the foot.

Pied droit varus
   

The métatarsus adductus

It is about a malposition of the foot characterized by a rocker in inside of the part before foot compared to the back part.
It is also one of the components of the club-foot varus equine.

Métatarsus adductus
   

The convex foot

It is about a deformation of the foot rarer than the club-foot varus equine, characterized by a plant of foot round (convex downwards), and radiographic anomalies.
The treatment is difficult and often surgical.

   

The foot direct slope

It is about a malposition of the foot characterized by an excessive dorsal inflection making that the back of the foot comes to touch the former face of the leg.
The forecast under treatment (rehabilitation and splints) is excellent.

Pied talus direct droit
Natural evolution of the club-foot (without treatment)  

The club-foot idiopathic does not have a natural tendency to spontaneous correction.
With time, the deformations solidify and the articulations become increasingly rigid.
Walk is possible but is done on the external edge of the feet, even the back of the feet, which is source of pains.

Pieds bots non traités à l'âge adulte (Inde)

Return in top of the page

| Home | What is a clubfoot | Images of clubfeet | History of the clubfoot | Treatments | Dr Ponseti | Méthod of Ponseti | Clubfoot and sports | To know more about it | Forum |
| Ordrers to the physiotherapists | Score of Diméglio | Bandages of Finck |
Glossary | Physiotherapy | Madam Bovary | Health Insurance | Anatomy | Radiology | Antenatal diagnosis | Questions-Answers |