Clubfoot is divided into different categories, depending on the cause and severity:

1. Idiopathic clubfoot:
   • Most common form with no known cause.
2. Syndromic clubfoot:
   • Occurs in connection with genetic syndromes such as arthrogryposis or trisomy 18.
3. Neuropathic clubfoot:
   • Caused by neurological disorders such as spina bifida.
4. Postural clubfoot:
   • Result of fetal position anomalies in the womb.

The exact causes of clubfoot are not fully understood. However, various factors play a role:

• Genetic predisposition:
  • Clubfoot occurs more frequently in families, indicating a genetic component.
• Mechanical factors:
  • Lack of space in the womb or an unfavorable position of the fetus can affect the development of the foot.
• Neurological causes:
  • Conditions such as spina bifida or muscular dystrophy can affect foot positioning.
• Syndromic associations:
  • Clubfoot can be part of a genetic syndrome.

The typical symptoms of a clubfoot are recognizable at birth:

- **Equinus position (Pes equinus):**

- The heel is elevated, and the foot cannot be placed flat.

- **Metatarsus adductus (Pes adductus):**

- The forefoot is turned inward.

- **Cavus foot (Pes cavus):**

- Excessive arching of the foot arch.

- **Varus position:**

- The foot is tilted inward, so the sole faces medially.

- **Limited mobility:**

- The foot cannot be actively brought into a normal position.

The diagnosis is usually made immediately after birth through clinical examination. In some cases, clubfoot can already be detected prenatally using ultrasound. Further diagnostic measures include:

• Clinical assessment:
  • Evaluation of the malposition and mobility of the foot.
• Imaging techniques:
  • X-rays: Used for precise assessment of bone structure and joint position.
  • Ultrasound: Non-invasive method for examining soft tissues and joints.

Conservative Therapy

The conservative treatment usually begins immediately after birth:

• Ponseti Method:
  • A gradual manual correction of the foot, followed by plaster casts that are changed weekly. After about 5–8 weeks, a percutaneous Achilles tendon tenotomy is often performed to correct the remaining equinus position. The follow-up treatment involves special braces to prevent relapses.
• French Method:
  • This method combines daily mobilization, bandages, and casts. It requires intensive cooperation from the parents.

Surgical Therapy

If conservative therapy is not sufficient, surgery may be necessary:

• Tendon Lengthening:
  • Shortened tendons are surgically lengthened to improve the mobility of the foot.
• Osteotomies:
  • Correction of misalignments of the foot bones through surgical procedures.

Since the exact causes are not fully known, there are no specific preventive measures. However, it is important:

1. Early diagnosis: Prenatal examinations can provide indications of clubfoot formation.
2. Prompt treatment: An early start of therapy significantly increases the chances of success.
3. Consistent follow-up treatment: Regular check-ups and wearing braces or orthoses reduce the risk of relapse.