My uncle just had his foot amputated from a condition he has had all his life called “clubfoot.” I am pregnant with my first child and thinking of all the family possibilities of things that can go wrong. Clubfoot is one of them. Is this hereditary and do they cut the foot off right away so the child doesn’t have to suffer like my uncle did his entire life?

Clubfoot also known as Congenital Talipes Equinovarus describes a position of the foot a baby is born with. The foot is turned under and towards the other foot. When broken down into its parts, equinovarus means that the toes are pointed down (equinus) with the ankle flexed forward (like the position of the foot when a ballet dancer is on her toes). Varus means tilted inward. The ankle is in varus when you try to put the soles of your feet together.

This twisted position of the foot causes problems. The ligaments between the bones are contracted, or shortened. The joints between the tarsal bones do not move as they should. The bones themselves are deformed. This results in a very tight, stiff foot that cannot be placed flat on the ground for walking. To walk, the child must walk on the outside edge of the foot rather than on the sole of the foot.

Until recently, most experts believed that the deformity was due to the foot being stuck in the wrong position in the womb. As development progressed, the foot could not grow normally because it was turned under and held in that position. Today, most information suggests that clubfoot is hereditary, meaning that it runs in families. It is not clear what genetic defect causes the problem. But just because your uncle has this condition is not a guarantee that your baby will have it, too.

The successful treatment of clubfoot today relies on a noninvasive method named for the surgeon who developed it: the Ponseti Method. This type of treatment is started as soon as possible. The foot is manipulated (moved) to stretch and loosen the tight structures. The foot is then placed in a cast to hold it in a corrected position. This is repeated every one or two weeks until the deformity is corrected or surgery is performed.

Sometimes a minor surgical procedure is required to lengthen the heel cord (fascia or connective tissue that connects the calf muscle to the heel bone). After casting is completed, the child wears a brace for several years. In the end, the results are excellent and amputation is not required. This treatment is a definite shift in how clubfoot is handled compared with when your uncle was a child.