Comprehensive Clubfoot Clinic
Clubfoot is a congenital condition in which one or both feet rotate inward at the ankle. It can impact your child’s ability to walk. At Children’s Hospital Los Angeles, our orthopaedic specialists can treat clubfoot without major surgery using the Ponseti method. This technique moves your child’s foot into the correct position through gentle manipulation and casts.
Our Expert Team
Our expert care team works together to provide compassionate, comprehensive care for your child throughout the treatment process. Our team includes:
- Orthopaedic surgeon
- Non-operative orthopaedic pediatrician
- Physician assistant
- Cast technician
Our team is nationally recognized for exceptional care. U.S. News & World Report ranked CHLA among the top 10 hospitals in the nation for pediatric orthopaedics in 2020-21.
What to Expect During Your Visit
We offer counseling for expectant mothers whose prenatal ultrasound shows orthopaedic disorders such as clubfoot. Our specialists closely review data including family history, etiology and treatment.
After your baby is born and has returned to birth weight — at around 2 to 4 weeks old — contact our clinic at 323-361-2142 to schedule your child’s first appointment.
First Visit with Your Child
At your first visit, our orthopaedic physicians will perform a comprehensive examination. First and foremost, the doctor will check if your child is healthy, eating well and gaining weight. Typically, we apply the first cast when your child is around 2 weeks old. Please bring a pacifier or bottle of milk on the day of casting to soothe your child.
The Ponseti Method
The Ponseti method has two phases: the corrective phase and the maintenance phase. In the corrective phase, doctors gently manipulate your child’s foot every week. The doctor applies new a cast each week to hold these changes in place. Then, in the maintenance phase, your child will wear a special brace to keep the foot in proper position.
The Corrective Phase: How Casting Works
First, our orthopaedic doctor will gently stretch your child’s foot. Next, we apply a cast to the lower leg to hold your child’s foot in the stretched position. Then, we apply a longer leg cast, which goes from the toes to the upper thigh, on top of the shorter cast. The long leg cast keeps the lower leg cast on and helps stretch the foot.
Every week for 4 to 8 weeks, our team will remove the cast, stretch the foot and apply a new cast. For older children, we may change the casts every 2 weeks.
At the end of the corrective phase, an orthopaedic surgeon will make an incision to reposition the heel tendon. Then, we will place a final cast on your child’s leg. Your child will wear this cast for another 3 weeks, during which time the tendon will heal.
How to Stay Comfortable During Casting
Casting can be tricky with infants and small children. Ideally, patients should feel relaxed and calm. Feeding them with a bottle or using a pacifier helps.
Some children may appear uncomfortable during the procedure, but the casting process itself is not painful. Your child may not like being unable to move the casted leg.
For older children, bring some toys they can play with while lying on their backs, or a favorite video to watch. Providing something to eat and drink while you are waiting may also keep your child from getting fussy before casting begins.
The Maintenance Phase: After Casting
After removing the last cast, our team will fit your child for a foot abduction brace. This brace consists of a special leg bar with shoes attached.
Your child will wear the brace for at least 3 months to hold the foot in the proper position and prevent the recurrence of clubfoot. Throughout this maintenance phase, our care team will closely monitor your child to ensure the best outcome.
If the foot rotates inward after bracing, we will treat it with casting again. Some children might require secondary procedures if casting does not fix the condition.