Congenital clubfoot anyone?
This gentleman, a longtime patient came in for new orthotics, as his old ones were 10 years old. From the pedographs above, you can see it is his LEFT foot.
Note the following:
- shortened apparent foot length left compared to right (the foot is merely deformed and plantarflexed)
- The increased plantar pressures laterally, from the foot being supinated
- increased arch height L > R
- clawing of digits 2-4 to provide stability
This case made me think about some common issues that you may be wondering about if you see these folks.
There are several things you should think about:
- People with clubfoot generally have a high arched, rigid, cavus foot.
- These folks generally are fixed in some degree of plantar flexion.
- Because of the plantar flexed posture of their foot, they generally have a loss of a ankle rocker
- If you utilize an orthotic with these patients, you need to make sure that there is significant ramp delta (heel higher than the 1st metatarsal)
- Clubfoot can often be unilateral.
- Clubfoot is usually not congenital
- Gait training and balance (proprioceptive) work can be especially helpful in these cases.