What is Clubfoot?

Clubfoot is a complex, congenital deformity of the foot also known as ‘congenital talipes equinovarus’ (CTEV) caused by the abnormal development of a baby’s bones, ligaments and muscles whilst in the womb (1).

Visually, the foot affected by clubfoot appears to be twisted inwards and downwards.  The foot will be shorter than a normal foot and the calf muscles of the affected limb will be smaller (2). The deformity will feel ‘fixed’ – not able to be corrected manually and will not resolve on its own (3).

Around the world, 150,000 – 200,000 babies with clubfoot are born each year.  Approximately 80% of these will be in low and middle income countries1. The incidence of clubfoot varies around the world.

Without treatment, the clubfoot deformity causes a lifetime of disability as the affected individual experiences pain and difficulty in walking. People with untreated clubfoot find it difficult to access education, employment and experience exclusion from society.

200,000

150-200,000 babies are born with Clubfoot worldwide each year.

Clubfoot incidence worldwide
Incidence /1000 live births Country Data Source
3.49 Australia: Aboriginal Carey M, Bower C, Mylvaganam A, Rouse I (2003) Talipes equinovarus in Western Australia. Paediatric Perinatal Epidemiology 17 (2): 187-194
1.11 Australia: Caucasian Carey M, Bower C, Mylvaganam A, Rouse I (2003) Talipes equinovarus in Western Australia. Paediatric Perinatal Epidemiology 17 (2): 187-194
1.6 Belgium Paton R, Fox A, Foster A, Fehily M (2010) Incidence and aetiology of talipes equino-varus with recent population changes. Acta Orthopaedica Belgica 76 (1): 86-89
1.2 Denmark Krogsgaard M, Jensen P, Husted H, Lorentzen J, Hvass-Christensen B, Christensen S, Larsen K, Sonne-Holm S (2006) Increasing incidence of club foot with higher population density: incidence and geographical variation in Denmark over a 16 year period. Acta Orthopaedica 77 (6): 839-846
6.8 Hawaii Dietz F (2002) The genetics of idiopathic clubfoot. Clinical Orthopaedics and Related Research 401: 39-48*
0.9 India Mittal R, Sekhon A, Singh G, Thakral H () The presence of congenital orthopaedic anomalies in a rural community. International Orthopaedics 17 (1): 11-12
0.87 Japan Yamamoto H (1979) A clinical, genetic and epidemiologic study of congenital club foot. Journal of Human Genetics 24 (1): 37-44
2 Malawi Mkandawire N, Kaunda E (2004) Incidence and patterns of congenital talipes equinovarus (clubfoot) deformity at Queen Elizabeth Central Hospital, Banter, Malawi. East and Central African Journal of Surgery 9 (2): 28-31
2.7 Papua New Guinea Culverwell A, Tapping C (2009) Congenital Talipes Equinovarus in Papua New Guinea: a difficult yet potentially manageable situation. International Orthopaedics (SICOT) 33: 521-526
0.76 Philippines Aguilar J (nd) Ponseti method for treating clubfoot in older children and children with previous unsuccessful subtalar releases: short term results. Accessed online at: www.ponseti.info/v1/index.php?option=com_content&task=view&id=66&Itemid=63 on 18/08/2010
1.4 Sweden Wallander H, Hovelius L, Michaelsson K (2006) Incidence of congenital clubfoot in Sweden. Acta Orthopaedica 77(6): 847-852
1.2 Uganda Pirani S, Maddumba E, Mathias R, Konde-Lule J, Penny N, Beyeza T, Mbonye B, Amoni J, Franceschi F (2009) Towards effective Ponseti clubfoot care: the Uganda Sustainable Clubfoot Care Project. Clinical Orthopaedics and Related Research 467: 1154-1163
1 USA Dietz F (2002) The genetics of idiopathic clubfoot. Clinical Orthopaedics and Related Research 401: 39-48*

Clubfoot can occur in either one or both feet – bilateral cases of clubfoot account for around 50% of cases. It is almost twice as common in males as in females1.

The exact causes of clubfoot are not known. Scientific studies have found that familial inheritance, genetics and environment are all likely to be factors which interact to cause clubfoot but how this happens is not well understood3.

The information provided by GCI is based on publications in scientific journals (references indicated by numbers within the text). To see the full reference list click here.