Treatments for Cleft Foot in Children

At Boston Children's Hospital, experts in our Orthopedic Center  provide comprehensive care—including evaluation, diagnosis, consultation, surgery, non-surgical therapies and follow-up care.

Whether to do surgery

Not all children need surgery for a cleft foot—it may not be necessary if your child has good use of her foot and the deformity is not too severe. However, if your child's foot has significant functional or cosmetic problems, her doctor may recommend surgery.

When to do surgery

Surgeons will perform surgery early in a child's life if the cleft foot's deformities are progressive (will worsen over time)—such as syndactyly (joining) between the toes, or transverse bones between the digits. If the cleft foot doesn't have progressive deformities, surgery can take place when the child is 1 or 2 years old.

Goals of surgery

If surgery is needed to repair a cleft foot, surgeons have many different approaches available. The timing and sequence of procedures will vary from child to child, but in general, the first procedure is usually done when, or after, a child is 1 or 2 years old—old enough to tolerate anesthesia and surgery well.

In general, the goals of surgery are:

   •   close the cleft and make sure your child can use his foot effectively
   •   reorganize the skin and soft tissue
   •   stabilize or transfer the bones of the foot

Caring for your child after surgery and into childhood

For about four to six weeks after surgery, your baby will be in a cast stabilized by pins. After this period, her doctor can remove the cast and pins in the office setting without sedation.

For several weeks, your child will wear a splint to bed to maintain alignment and help with scar reduction. She'll receive occupational therapy until she achieves supple active motion and developmentally appropriate use of her foot, during which time her doctor will monitor her progress monthly. The doctor will then follow her yearly until she stops growing (reaches skeletal maturity).

Long-term outlook

The quality of the reconstruction of your child's foot depends to a large extent on how severe her original malformation was. As a result of surgery, you can expect that she will have a functional foot and an improvement in her foot's appearance. The alignment of her toes should also improve.

As your child grows, some gaps and deformities that were reconstructed by her original surgery can recur. In these cases, additional procedures may be needed.

Coping and support

At Boston Children's Hospital, we understand that a hospital visit can be difficult, and sometimes overwhelming. So, we offer many amenities to make your child's—and your own—hospital experience as pleasant as possible. Visit The Center for Families for all you need to know about:

   •   getting to Boston Children's
   •   accommodations
   •   navigating the hospital experience
   •   resources that are available for your family

In particular, we understand that you may have a lot of questions when your child is diagnosed with cleft foot. Will this affect my child long term? Will she be able to enjoy regular activities? Boston Children's can connect you with extensive resources to help you and your family through this stressful time, including:

Patient education: From doctor's appointments to physical therapy and recovery, our nurses and physical therapists will be on hand to walk you through your child's treatment and help answer any questions you may have—Why will my child need surgery? Are there non-surgical options? How long will her recovery take? How should we manage home exercises and physical therapy? We'll help you coordinate and continue the care and support your child received while at Boston Children's. 

Parent-to-parent: Want to talk with someone whose child has been treated for cleft foot? We can often put you in touch with other families who've been through the same process that you and your child are facing, and who will share their experiences.   

Faith-based support: If you're in need of spiritual support, we'll connect you with the Boston Children's chaplaincy. Our program includes nearly a dozen clergy—representing Protestant, Jewish, Muslim, Roman Catholic and other faith traditions—who will listen to you, pray with you and help you observe your own faith practices during your hospital experience.    

Social work: Our social workers and mental health clinicians have helped many families in your situation. We can offer counseling and assistance with issues such as coping with your child's diagnosis, stresses relating to coping with illness and dealing with financial difficulties.