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Cleft Foot in Children

  • "Our chief surgical goals with cleft foot are to close the cleft and to optimize the foot's function and appearance. At Children's, we take an individualized approach to each child's limb difference or congenital difference - including for this extremely rare condition - because no two cases are alike."

    --Samantha Spencer, MD, orthopedic surgeon, Boston Children's Hospital

    At Boston Children's Hospital, we understand your concern if your baby was born with a cleft foot. Our Orthopedic Center will approach your child’s condition with care and support—for your child and your whole family.

    • A diagnosis of cleft foot means that your child’s foot has a deepened space that extends toward the ankle; there may be missing toes or other anatomical anomalies.
    • Clefts are usually V-shaped.
    • The condition is present and visible at birth (congenital).
    • There’s a clear genetic basis for a typical cleft foot—the condition is commonly thought to be inherited.

    Cleft foot can occur:

    • by itself (in isolation)
    • along with a similar cleft of the hand (called split hand-split foot malformation, [SHFM] or ectrodactyly)
    • as part of a genetic syndrome
    • The condition in isolation is extremely rare, and is estimated to affect fewer than 1 in 1,000,000 babies.
    • Most affected children—except those with very mild cases—need one or more surgeries, usually starting at around 1 or 2 years of age, when a child can tolerate surgery and anesthesia well.
    • Surgery’s first goal is to improve the foot’s function.
    • The second goal is to improve the foot’s shape and appearance, preferably before the child becomes aware that her foot looks different from those of other children.
    • Surgically re-shaping the foot increases the chances of the child being able to wear off-the-shelf shoes, instead of costly custom-made shoes.
    • When planning surgery, the surgeon must consider not just the bones of the foot, but also soft tissue, such as ligaments and nerves.

    How Boston Children's Hospital approaches cleft foot
    The Orthopedic Center's Lower Extremity Program offers comprehensive assessment, diagnosis, surgical and non-surgical treatment of infants, children and teens with complex disorders of the lower extremities, including cleft foot.

    With more than 5,000 pediatric visits per year, our multidisciplinary team of fellowship-trained, board-certified, pediatric orthopedic surgeons is one of the most experienced in the country.

    Our Orthopedic Center—one of the first of its kind in the nation—is internationally known as a premier center for the orthopedic care of infants, children and young adults. You can have peace of mind knowing that our skilled experts have treated thousands of babies and children with cleft foot and other upper and lower limb problems. We provide expert diagnosis, treatment and care, and our patients benefit from Children’s advanced clinical and scientific research.

    Cleft foot: Reviewed by 

    Samantha Spencer, MD

    © Boston Children's Hospital, 2011

The future of pediatrics will be forged by thinking differently, breaking paradigms and joining together in a shared vision of tackling the toughest challenges before us.”
- Sandra L. Fenwick, President and CEO