PT Corner: Positional Clubfoot

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by Rebecca Talmud, PT, DPT owner of Dinosaur Physical Therapy as appeared on the Dinosaur PT blog

clubfoot

Positional Clubfoot or Talipes (from the Latin compound of “talus” ankle and “pes” foot) is a misunderstood, misrepresented and many times mistreated condition which affects approximately 1 in 1,000 children.  For most, the term Clubfoot brings to mind a bony deformity, a structural anomaly that requires intensive often aggressive intervention.  But Positional Clubfoot refers to a flexible “normal” foot that was held over time in an abnormal position in utero. When the child is born, due to the prolonged positioning, most commonly they present with one or both feet in an abnormal resting position.  Bony alignment is not impacted and foot position is usually corrected by conservative treatment (a comprehensive program of stretching, range of motion, weight bearing, and massage).  Management requires time and attention to undo the positional constraints imposed during the baby’s compressed time in utero.  Long term prognosis of Positional Clubfoot reveals most cases resolve without gait abnormalities as the child matures and develops.  Is the label “Positional Clubfoot” causing confusion, could we relabel this truly benign condition to better emphasize its meaning?

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