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At Luskin Orthopedic Institute for Children (LuskinOIC), our Center for Clubfoot includes a team of specialty-trained doctors, cast technicians, orthotists, and physical therapists who work together to provide award-winning care and ensure that every child with clubfoot is making progress to reach that all-important goal: to walk, run, and play just like any other child.
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Clubfoot is a birth defect that causes one or both of a baby’s feet to turn inward, or to point upward. This occurs because the tendons that connect the leg muscles to the foot are short and tight, causing the foot to twist and bear a rough resemblance to a golf club. Clubfoot affects one out of every 1,000 babies in the U.S. — making it one of the most common congenital foot deformities. It’s not usually a painful condition, but it needs to be treated early so your child can walk normally later.
Most of the time, clubfoot can be detected before a child is born with a prenatal ultrasound. The diagnosis can be confirmed after birth with a physician exam. In rare cases, your doctor may request X-rays to determine the severity of your child’s clubfoot.
Clubfoot is a birth defect that causes one or both of a baby’s feet to turn inward, or to point upward. This occurs because the tendons that connect the leg muscles to the foot are short and tight, causing the foot to twist and bear a rough resemblance to a golf club. Clubfoot affects one out of every 1,000 babies in the U.S. — making it one of the most common congenital foot deformities. It’s not usually a painful condition, but it needs to be treated early so your child can walk normally later.
Most of the time, clubfoot can be detected before a child is born with a prenatal ultrasound. The diagnosis can be confirmed after birth with a physician exam. In rare cases, your doctor may request X-rays to determine the severity of your child’s clubfoot.
The goals of clubfoot treatment are to make the foot (or feet):
- Functional
- Flexible
- Painless
- Positioned so that the child can stand and walk normally
The clubfoot treatment process can be intense. It requires extensive time and effort, especially during the bracing stage. But eventually, your child will reach the end of treatment, and will be able to wear regular shoes and walk normally.
Keep in mind that if the clubfoot affected only one foot, that foot might be 1 to 1½ shoe sizes smaller than the other. The muscles in the leg of the affected foot are underdeveloped and the calf might look smaller. In some cases, the leg is slightly shorter.
Unfortunately, even after treatment, clubfoot has a strong tendency to come back until your child is about 5 to 7 years old, but bracing can help prevent these relapses. In fact, 90% of clubfoot cases relapse if bracing is stopped in the first year. That’s why consistent bracing, for the length of time recommended by your doctor, is so important! By the fourth year of bracing, the relapse rate drops to 10% to 15%. After that, only about 6% of clubfoot cases relapse.
Warning signs of relapse can be hard to spot if you don’t know what to look for. Talk to your child’s doctor at LuskinOIC right away if:
- Your child puts more weight on the outside part of the sole of the foot when walking
- Your child’s foot is routinely slipping out of the bracing boot
- Your child’s heel turns inward or outward
There are 2 types of clubfoot:
- Isolated (or idiopathic) clubfoot: If your child has isolated clubfoot it usually means they do not have other related medical conditions. This is the most common and easily treated type of clubfoot.
- Non-isolated clubfoot: If your child has other medical conditions — like Arthrogryposis or spina bifida — then their clubfoot is called non-isolated clubfoot. This type can be more challenging to treat.
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Setting the standard in treating Hemohilia
At LuskinOIC’s Orthopaedic Hemophilia Treatment Center (OHTC), we set the standard in treating hemophilia joint and limb issues. In 1970, OHTC was designated by the World Federation of Hemophilia as one of the first four International Hemophilia Training Centers.
We’ve consistently been pioneers for our patients: we were the first comprehensive care center on the West Coast, we performed the first successful hip replacement surgery in a patient with hemophilia, and through clinical trials we have been providing the newest treatments available.
In addition to treatment, we conduct groundbreaking research, provide innovative and personalized physical therapy, and offer genetic counseling for patients and their families.
Why LuskinOIC for Clubfoot?
At the Center for Clubfoot, our renowned specialists and team will be there to help you and your child with a full range of treatment and support services, including:
- Onsite diagnostic imaging, such as X-rays
- Clubfoot treatment customized to your child
- Guidance, care and support during and after each phase of treatment
- Surgery, if necessary
Our Approach
At LuskinOIC, our preferred treatment for clubfoot is a 3-stage process called the Ponseti method which involves stretching, casting and bracing. Research has shown the Ponseti method is 95% effective when used properly. Learn more about the Ponseti method here.
Treatment usually starts in the first 2 weeks after birth. We’ve also achieved excellent results treating children referred to us at an older age.
Stage 1: Stretching and Casting
- Timeline: 4 to 6 weeks
- During this first stage of treatment, a LuskinOIC clubfoot specialist will gently manipulate your baby’s foot through stretching into the right position. A long-leg cast that spans from the toes to the thigh will be applied to hold your baby’s foot in place.
- This step will be repeated weekly for 4 to 6 weeks. Once the foot is in the proper position, the treatment moves into Stage 2.
Stage 2: Achilles Tenotomy
- Timeline: 3 weeks
- Next is a quick, minor medical procedure called an Achilles tenotomy. Your baby’s surgeon will make a tiny cut in the Achilles tendon (the cord behind the heel), which will allow the tendon to lengthen and be more flexible as it grows back. Because it is such a small incision, your child won’t need stitches.
- After the procedure, your baby will receive a new cast. The cast will be removed when the tendon has healed at the right length and the foot is completely corrected.
Stage 3: Bracing
- Timeline: 3 to 5 years
- Once Stage 2 is complete, your child will need to wear a brace for a few years to keep the clubfoot from recurring. This brace is sometimes called the “boots and bar” brace (because it’s made of two shoes connected by a metal bar). Some bars allow each leg to move on its own, while others only allow both feet to move together. The brace may look uncomfortable, but should not hurt or bother your child. Your child will learn how to crawl, sit and walk with the brace on, just like other kids their age. Learn More
- The brace is usually worn for 23 hours each day for the first 3 months. After that, your child might have to wear it during nap time and overnight (about 12 to 14 hours a day) for 3 to 5 years.
Stretching Exercises for Clubfoot
Your child’s doctor may recommend stretching exercises to help improve flexibility and strengthen your child’s clubfoot. If they believe additional strengthening is needed, your child may be referred to physical therapy.
Exercises may include:
- Ankle Dorsiflexion Exercises: Place the palm of your hand under your child’s foot and put the other hand on your child’s flexed knee. Gently flex the ankle up and out. Hold this position for 10 seconds and repeat 10 times.
- Ankle Eversion Exercises: Place a hand around the calf of your child’s leg and the other hand around the base of the great toe. Gently, bring the foot outward. Hold this position for 10 seconds and repeat 10 times.
Telemedicine
If visiting our center in Los Angeles isn’t convenient, one of our specialists can assess your child’s clubfoot by utilizing telemedicine technology, such as videoconferencing, still and video images, or telephone consults.
For Medical Professionals
We provide different type of medical services.
Family Medicine
Emergency Medicine
Pediatric Orthopedics
Orthopaedic Oncology
Urgent Care
Arthrogryposis
Bone and Soft Tissue Tumors
Cerebral Palsy
Sports Medicine
Congenital Limb Disorders
Skeletal Dysplasia & Dwarfism
Clubfoot
Scoliosis
Rehabilitation Center
Hip Disorders
Hand and Microsurgery
Hemophilia
Craniofacial and Cleft Palate
Connective Tissue Disorders
Fractures
Our Experts
Physicians: Make a Referral to LuskinOIC Center for Clubfoot
When you refer your patients to LuskinOIC’s Center for Clubfoot, we’ll do everything possible to provide the expert orthopedic care they need. For more than 100 years, our specialists have helped thousands of children recover from clubfoot and live normal, active lives.
We also offer telemedicine. If visiting us in LA is not convenient for your patient’s family, one of our specialists can assess clubfoot in a patient who is potentially miles away by using HIPAA-compliant technology including videoconferencing, still and video images, e-health (including patient and physician portals) and telephone consults.
The J. Vernon Luck, Sr., MD Orthopaedic Research Center (JVL) at LuskinOIC is also committed to developing a deeper understanding of the biology and biomechanics of the musculoskeletal system, and to applying this knowledge to improve orthopedic materials, implants, surgical instrumentation, surgical techniques, and the overall quality of care to orthopedic patients world-wide. The researchers at JVL, in close collaboration with LuskinOIC orthopedic surgeons, have published many studies on the treatment, outcome and biomechanics of idiopathic clubfoot. An institutional review board (IRB) approved database of more than 300 infants treated at LuskinOIC has been established to study all aspects of clubfoot treatment.
Referring Physicians for LuskinOIC Center for Clubfoot: (213)742-1109
Medical Professional's Help Line: (213) 741-8325
Fax Referrals: (213) 741-8338
Hours: 8:00 AM - 4:00 PM, Monday-Friday