Congenital foot deformities 

Congenital foot deformities are foot conditions that babies are born with. If your child has a congenital foot deformity, we are here to help. Our team of pediatric orthopedic surgeons are experts in all types of congenital foot deformities and will work with you to find the best treatment options available, including surgical and non-surgical treatments and rehabilitation therapy.

What are congenital foot deformities?

Congenital foot deformities are birth defects that affect the structure, function and appearance of your child’s foot. These conditions can range from mild to severe, sometimes impacting mobility or requiring treatment. These can affect the bones, muscles, tendons, or skin, leading to conditions such as webbed toes (syndactyly), clubfoot and cleft foot.

Most congenital foot deformities develop in the womb. Some children may experience alignment deformities of the forefoot or more complex issues like tarsal coalition or cavus foot after birth.

Webbed toes

Webbed toes, also known as syndactyly, is a condition where two or more toes are fused together by skin, tissue or even bone. It occurs when the tissue that normally separates the toes during fetal development fails to completely divide.

Webbed toes are relatively common and are usually found between the second and third toes. In most cases, they do not cause any functional problems or pain. However, in some instances, syndactyly may require surgical correction for cosmetic or functional reasons, especially if the webbing is extensive or affects mobility.

Treatment options depend on the severity of the condition, but surgery is generally considered if there is significant fusion or if it's causing difficulties with walking or wearing shoes.

Cleft foot

Cleft foot, also known as ectrodactyly or split foot, is a rare deformity where there is an abnormal split in the middle of the foot. This condition results in missing toes or a deep V-shaped cleft between the toes, giving the foot a "lobster claw" appearance.

Cleft foot can affect one or both feet and is often part of a broader condition called ectrodactyly-ectodermal dysplasia-clefting syndrome (EEC syndrome), which can also involve abnormalities in the hands, skin, teeth and other parts of the body.

The cause of cleft foot is generally genetic, though the exact cause may vary. It’s often linked to a mutation in specific genes involved in limb development during pregnancy.

Treatment for cleft foot may involve surgery to improve the appearance and function of the foot, especially if it affects mobility or causes discomfort. Custom shoes or orthotic devices may also be used to help your child walk more comfortably. In mild cases, treatment might not be necessary unless there are functional issues.

Claw foot

Claw foot, also known as claw toe, is a condition where the toes bend into an abnormal shape, resembling a claw. The toes curl upward at the joint where they meet the foot and then downward at the middle and end joints. This deformity can affect one or more toes and is often seen in the smaller toes.

Claw foot can be caused by various factors, including nerve damage, wearing shoes that are too tight, trauma or other conditions, such as arthritis, cerebral palsy or stroke.

Treatment options depend on the severity of the deformity. In mild cases, stretching exercises, orthotic devices and special shoes may help alleviate discomfort. For more severe or rigid cases, surgery may be necessary to release tendons or realign the bones in the toes.

How rare are congenital foot deformities?

Foot deformities range from common to rare, depending on the type. Some, such as clubfoot, are common. Webbed toes, or syndactyly, affect about 1 in 2,000 to 3,000 births. However, rare conditions such as cleft foot and forefoot malformations happen less frequently. While some foot deformities are more prevalent in families, the severity and type of deformity can differ greatly from child to child.

What causes congenital foot deformities?

The causes of congenital foot deformities are not always understood. Many are due to genetic defects, while others may be linked to birth trauma or developmental abnormalities in the womb.

Potential causes include:

• Genetic defects: Many foot deformities, such as syndactyly and clubfoot, are hereditary. Families with a history of foot deformities may pass these conditions on to their children.
• Birth trauma: Occasionally, trauma during birth can lead to abnormalities in a baby’s feet, particularly in cases of complicated or prolonged deliveries.
• Developmental or positional abnormalities: Foot deformities can occur if a baby’s position in the womb restricts their movement or affects foot development. This is particularly true for conditions like clubfoot.
• Environmental factors: In some cases, exposure to certain environmental factors such as cigarette smoke or pollution during pregnancy may help develop foot deformities.

Congenital foot deformity diagnosis

Diagnosing congenital foot deformities typically begins with a physical examination shortly after birth. In some cases, deformities can be detected during routine prenatal ultrasounds or are noticeable at birth.

In addition to physical exams, your child’s doctor may recommend imaging tests, such as X-rays or ultrasounds, to evaluate the bones, joints and soft tissues in the foot. These tests help determine the severity of the deformity and guide the treatment plan.

What treatments are available for congenital foot deformities?

The treatment for congenital foot deformities depends on the type and severity of the condition. We offer both non-surgical and surgical treatments, based on your child’s unique needs.

For mild to moderate deformities, non-invasive methods are often effective. These may include physical therapy, occupational therapy, stretching exercises or the use of orthotic devices such as braces or custom shoes to correct alignment. Conditions like mild syndactyly and some forms of clubfoot typically respond well to non-surgical approaches.

In more severe cases, surgery may be required to correct the deformity. Surgical procedures aim to realign the bones, tendons or muscles to improve function and appearance. For example, severe webbed toes may be separated surgically, and congenital clubfoot may require procedures to adjust the position of the foot.

In addition to correcting physical deformity, the goal of treatment is to ensure your child can walk, run and participate in activities without pain or discomfort.