How is clubfoot treated, and how successful is the treatment?

The goal of treatment is a painless, flexible foot that strikes the ground in proper position when walking. Regardless of the severity or rigidity, the initial treatment is nonoperative, using repeated sequential castings, also called “serial castings.” The goal of this kind of treatment is to limit the amount of surgery required.

Nonoperative treatment involves weekly serial castings to promote gradual correction of the foot over six to eight weeks. Following this casting regimen, nearly all children require a short outpatient surgical procedure to fully correct the foot. Then a special brace is worn full time for eight to nine months and part time for two to three years.

The ability to completely correct the clubfoot deformity depends on each child’s unique initial severity and rigidity, the age at which treatment is started, the skill of the orthopedic surgeon, and the definition of complete correction. Although the position of the foot may be dramatically improved with treatment, nearly all patients with clubfoot have a difference in calf size, foot size, and possibly overall limb length compared to unaffected limbs. Eighty percent of children have a painless functional foot following serial manipulation and casting.