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There are many ways you can help children and their families get the care they need.
At Boston Children's Hospital, our orthopedic experts know that it’s distressing to learn that your baby has a cleft foot. We’ve pioneered innovative surgical treatments for children with all types and variations of cleft foot.
Cleft foot is a rare congenital (meaning your baby was born with it) anomaly in which the foot didn’t develop properly during fetal development. This causes the affected foot to have missing toes, a V-shaped cleft and other anatomical differences.
Cleft foot is generally understood to have a genetic cause.
Cleft foot can occur by itself; with cleft hand (ectrodactyly, also called split hand-split foot malformation); or as part of a genetic syndrome.
Cleft foot is very rare, affecting fewer than 1 in 1,000,000 babies.
It really depends on the severity of the problem. Surgery can usually improve the foot’s function, especially since the heel, which remains normal, is the area of the foot that’s most needed for walking. So, for both cosmetic and cost reasons, the main issue is: Can your child’s affected foot fit into an off-the-shelf shoe? Our doctors work hard to re-shape the foot so that a child can wear regular shoes, rather than specially made ones.
No, a child doesn’t typically experience pain as a result of cleft foot.
Signs of cleft foot are visible at birth, and increasingly, on prenatal ultrasound.
• The baby’s foot has missing toes, a V-shaped cleft and possibly other anomalies.
In the majority of children who have it, a cleft foot may be an isolated occurrence, affecting only her foot. But your doctor will also check for any associated deformities or syndromes.
If a fetal ultrasound reveals that your baby has a cleft foot, you’ll be referred to an orthopedic specialist, who will help you plan for your child’s care after she’s born. If you haven’t learned during your pregnancy that your child has a foot problem, the cleft foot will be visible when your baby is born, and you will be referred to a lower limb specialist.
Lots of parents find it helpful to write down questions as they occur to them before their appointment—that way, when you talk to your child’s doctors, you can be sure that all of your concerns are addressed.
Some questions you could ask are:
• Why did my child develop a cleft foot? (You would ask this if neither your partner nor you have a cleft foot.)
• What will x-rays reveal beyond what is visible to the eye?
• What are the associated conditions, if any, with a cleft foot?
• Is surgery necessary, and if so, what does it entail? Are there alternative therapies?
• Will my child be OK after surgery? Could there be complications?
• Will my child recover full function of her foot? Will it look OK?
• Will there be restrictions on her activities or capabilities?
• Will my child need physical therapy?
• What will be the long-term effects?
• What can we do at home?
As your child grows, some gaps and deformities that were reconstructed by original surgery can recur. In these cases, additional surgery or surgeries may be needed.
If your baby was born with a cleft foot—or if you’re expecting a child who will have a cleft foot—you’re probably disappointed that your child and your family are facing a complicated path so early in her life. If you feel frustrated or depressed, speak to your doctor or counselor to get help. Professionals in Boston Children’s Center for Families can provide you with important resources and referrals.
• The Center for Families at Children’s: dedicated to helping families find the information, services and
resources they need to understand their child’s medical condition and take part in their care
• autosomal dominant: genetically predisposed to have the same trait as a parent; in the case of cleft foot, if a
parent has the condition the child has a strong chance of having it, as well.
• cleft foot: the foot has a deep cleft that extends towards the ankle; is missing toes; and can have highly variable
deformities. Clefts are usually V-shaped.
• congenital: present at birth
• embryonic development: development of the fetus in the womb
• in isolation: a condition that occurs “by itself,” rather than as part of a larger syndrome
• in utero: in the womb (uterus)
• occupational and physical therapy: services offered by trained professionals to help restore function or
(re)teach basic life skills, like dressing oneself or grasping objects
• orthopedics: the medical specialty concerned with diagnosing, treating, rehabilitating and preventing disorders
and injuries to the spine, skeletal system and associated muscles, joints and ligaments
• orthopedic surgeon, orthopedist: a physician specializing in surgical and non-surgical treatment of the spine,
skeletal system and associated muscles, joins and ligaments
• post-operative (post-op): occurring after surgery
• prenatal (fetal) ultrasound: ultrasound performed at several stages of pregnancy; can often detect cleft foot
in the fetus
• pre-operative (pre-op): occurring before surgery
• range of motion (ROM) exercises:physical therapy exercises designed to improve or restore flexion and
extension of joints
• reconstructive surgery: surgery performed to repair and/or restore a body part to normal or as near normal
• sporadic: occurring without apparent cause
• x-rays: a diagnostic test that uses invisible electromagnetic energy beams to produce images of internal tissues,
bones, and organs onto film
We are grateful to have been ranked #1 on U.S. News & World Report's list of the best children's hospitals in the nation for the third year in a row, an honor we could not have achieved without the patients and families who inspire us to do our very best for them. Thanks to you, Boston Children's is a place where we can write the greatest children's stories ever told.”