Treatments for Clubfoot in Children

At Boston Children's Hospital's Orthopedic Center, our specialists provide comprehensive treatment—including evaluation, diagnosis, consultation and follow-up care.

Will my child be OK?

Clubfoot isn’t usually painful to the baby or child. Babies and children usually do very well today with the "Ponseti" regimen and good follow-up care. Major surgery is rarely needed to achieve a highly functional foot. However, 20 to 30 percent of treated kids need additional intervention sometime in their childhood for tendon tightness, or to prevent recurrence.

Parents and children can be very heartened to know that some of America’s finest athletes had clubfoot as children. These include Pittsburgh Pirates infielder Freddy Sanchez; pro soccer star Mia Hamm; Olympic skater Kristi Yamaguchi; and Dallas Cowboys quarterback Troy Aikman.

What is the "Ponseti" method?

Our standard of care for clubfoot is the “Ponseti” method, in which the foot is manipulated into correct position without joint surgery. Usually begun immediately after birth, the method involves:

•   a two to three-month regimen of stretching/overstretching and repositioning  using casts that get changed every
    few weeks
•   for about 95 percent of babies, when the casting period is over, surgery (tenotomy) to release and lengthen the
    Achilles heel; this procedure is performed at Children's usually under local anesthesia
•   a bracing regimen (see description, next paragraph) that lasts for several years—a crucially important step,
    requiring full family attention and compliance

Learn more about our care tips for cast maintenance.

Bracing treatment for clubfoot

Doctors at Boston Children's stress that the bracing component of the treatment for clubfoot is absolutely critical. The bracing program is full-time (about 22 hours a day) until the baby is about 6 months of age. At 6 months, we generally scale back to bracing just at night and at nap time—about 15 or 16 hours a day—and the baby goes without the brace while he's awake. When the baby is ready to learn how to crawl, and then walk, run and play, the brace is off. 

Strictly following the bracing program until the child is about 4 years old (despite the understandable inconvenience) is the best prevention against recurrence and the need for further intervention.

Coping and support

At Boston Children's, we understand that a hospital visit can be difficult. So, we offer many amenities to make your child's—and your own—hospital experience as pleasant as possible. Visit the Hale Family 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 a clubfoot. Will my child need surgery? When will his foot be normal? Will it affect him long term? Children's can help you connect with extensive resources to help you and your family through this stressful time, including:

•    patient education: From doctor's appointments to treatment to follow-up, our nurses and physical therapists
     will be on hand to walk you through your child's diagnosis, treatment and follow-up care. 
•    parent-to-parent: Want to talk with someone whose child has been treated for clubfoot? Our Orthopedic
can often put you in touch with other families who've been through the same experience that you and
     your child are facing. 
•    faith-based support: If you're in need of spiritual support, we'll connect you with the Children's chaplaincy. Our
     program includes nearly a dozen clergy—representing Protestant, Jewish, Muslim, 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 other 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 issues.