Cleft Foot


What is 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 very rare, affecting fewer than 1 in 1,000,000 babies.

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?

Cleft foot occurs by itself (in isolation) along with a similar cleft of the hand, called split hand-split foot malformation (SHFM) or ectrodactyly. 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 their 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.

What causes cleft foot?

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.

What are the signs and symptoms 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.

How we care for 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.