Club foot repair

Alternative names
Repair of club foot; Foot tendon release; Club foot release

Definition
Club foot repair is surgical correction of a birth defect of the foot and ankle (club foot).

Description

The type and extent of surgery depends on the how severe the deformity is. The defect involves tight and short tendons around the foot and ankle. The surgery involves lengthening some tendons and shortening other tendons to place the bones and joints in normal positions. A cast is applied to the foot after surgery to maintain its position while it heals.

Indications

The newborn’s club foot is initially 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 light-weight cast is applied to retain the corrected position.

The cast will be removed every week or two so the foot can be further stretched into better position and maintained with a new cast. This series of casting is continued for three or more months and is successful in at least 50% of cases.

If the casts do not provide enough correction of the club foot, surgery is considered. Surgery is also considered if the club foot is recurrent (happens after already being treated previously) or if it is associated with neuromuscular disorders.

Risks
Risks for anesthesia include the following:

     
  • Reactions to medications  
  • Breathing problems

Risks for surgery include the following:

     
  • Bleeding  
  • Infection

Expectations after surgery

If surgery is necessary, the foot usually becomes quite functional. Physical therapy may help keep the foot in good position and help improve function and flexibility.

In some cases, the child’s foot and calf may remain smaller than normal throughout life. Although the scars and cosmetic appearance of the foot may sometimes remain displeasing, the corrected club foot is generally very functional.

Convalescence

The child will stay in the hospital for approximately two days after surgery. The foot will be casted and kept elevated, with ice packs used to reduce swelling and pain. Medications can be used for pain. The skin around the cast and the toes will be checked frequently for the first 48 hours to make sure that the circulation, movement, and feeling are maintained.

Before leaving the hospital, the parent will be taught how to take care of the cast. The cast is usually left on for about three months. Physical therapy is usually required after the cast is removed to strengthen the muscles in the repaired foot.

Possible complications include skin irritation or infection.

Johns Hopkins patient information

Last revised: December 3, 2012
by Martin A. Harms, M.D.

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