Clubfoot deformity (the foot curves in and points down) is a common birth defect. About half the children have unilateral clubfoot, meaning it only affects one foot. The other half have bilateral clubfoot, affecting both feet.
Without treatment, the child walks on the sides of the feet. If severe enough, the child may even walk on the ankle instead of the bottom of the foot.
Early treatment to balance the soft tissues and realign the bones is needed to restore the normal anatomy of the foot and ankle. Treatment may begin with a series of casts and splints used to bring the foot and ankle back into a midline or neutral position. Minor surgery to release tendons in the area may be needed. When the child is older, a tendon transfer to correct a persistent muscle imbalance may be required.
Most children with corrected clubfoot appear to walk quite normally. Sometimes the affected foot (if unilateral) may be smaller than the other foot. The calf can be noticeably smaller than the normal side.
Specific testing of children with unilateral clubfoot compared to children without clubfoot has been done. The researchers found that the weight-bearing pattern for children with unilateral clubfoot was different on both sides compared to children who don’t have this condition.
It appears the leg and the nervous system have some compensatory mechanisms to ensure the child stays symmetrical (even) from side to side. None of this is noticeable to the child or the observer.