Clubfoot and vertical talus affect the position of a baby’s foot or feet. Babies born with clubfoot have tendons in the leg and foot that are shorter than usual. As a result, the foot pulls into an abnormal position. The foot may point downward and turn inward towards the other leg, almost as if the foot is upside down.
Babies born with vertical talus have an improperly positioned talus bone, the bone connecting the foot and leg. As a result, the foot turns outward, creating a rigid, flat foot. This condition is sometimes called “rocker bottom” because the foot arch curves like the bottom of a rocking chair.
Both of these foot conditions are treatable.
Foot Disorder Treatments: Why Choose Us?
If your unborn baby has a foot disorder, doctors at the Fetal Care Center partner with orthopedic specialists at the Center for Foot Disorders at St. Louis Children’s Hospital. These doctors are Midwest leaders in treating children born with clubfoot and vertical talus, offering both nonsurgical and surgical treatment options.
About Clubfoot and Vertical Talus
Clubfoot is a common birth defect, affecting approximately 1 out of every 1,000 newborns. Vertical talus is less common, affecting about 1 out of every 10,000 newborns.
These conditions may affect one foot or both, with problems ranging from mild to serious. While clubfoot and vertical talus aren’t painful, the conditions affect a baby’s ability to stand and walk.
Babies with clubfoot may have other conditions, including:
- Spina bifida: A condition that exposes the spinal cord and nerves
- Hip dysplasia: A condition where the top of the thighbone slips in and out of the hip socket
- Arthrogryposis: A condition that causes a joint to become permanently bent (flexed) or straightened
Causes of Clubfoot and Vertical Talus
There is no known cause of clubfoot or vertical talus. However, certain factors increase a child’s risk, such as:
- Gender: Boys are twice as likely as girls to have clubfoot. Vertical talus affects both genders equally.
- Family history: If you have a child with clubfoot, you may have a slightly greater chance of having another child with the condition. Vertical talus is not inherited. Our genetic counselors can help you understand your future risk.
- Low amniotic fluid: Conditions such as bladder outlet obstruction and hydronephrosis decrease the amniotic fluid that cushions and protects your unborn baby. Clubfoot may occur because there is less womb space in these cases.
Diagnosing Clubfoot and Vertical Talus
We use the latest 3-D ultrasound technology to diagnose foot disorders in unborn babies. A maternal-fetal specialist is always present during these tests to provide timely information about your unborn baby’s condition. Our special focus on ultrasounds makes us experts in catching problems early. Learn more about high-risk pregnancy tests.
Treating Clubfoot and Vertical Talus
Your baby won’t need treatment until after birth. Most women are able to have a vaginal delivery.
During pregnancy, you discuss treatment options with orthopedic experts from the Center for Foot Disorders at St. Louis Children’s Hospital.
Treatment options include:
- Ponseti method: This nonsurgical treatment begins within two weeks after birth. Your doctor stretches your baby’s foot towards the correct position and casts the leg from the toes to upper thigh. Your doctor repeats this process every week for up to three months. Learn more about the Ponseti method.
- Surgery: If nonsurgical treatments do not work or the foot problem is severe, surgery is an option. Our pediatric orthopedic surgeons lengthen the tendons to treat clubfoot or fix bone problems to treat vertical talus. Your baby wears a cast for six to eight weeks after surgery.
- Clubfoot bar: After the last Ponseti cast or surgery, children with clubfoot or vertical talus wear a brace 23 hours a day for two to three months. Dr. Matthew Dobbs, an orthopedic surgeon at St. Louis Children’s Hospital, developed the Dobbs Dynamic Clubfoot Bar, or Dobbs Brace. This brace allows children to be active and move their legs independently while still providing needed support. Learn more about the Dobbs Dynamic Clubfoot Bar.
To make an appointment with a Washington University fetal care specialist at the Women & Infants Center, call 855.925.0631.