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Dear Doctor

August 2018

Question:

My son had club feet in both legs. He was done with casting at the age of 10 days and then he started wearing brace shoes. Now he is one year old. He stands but has not started walking. I am worried about his walking issue and how much time it will need to cure completely?

- Sadiya - India (Parent)

Answer:

Thank you very much for your question. Clubfoot is the most common foot disorder that pediatric orthopaedic surgeons treat. In the past, untreated clubfoot was a severely debilitating condition that would become crippling in a person’s adult years. Now, through the groundbreaking work of Dr. Ignatio Ponseti and his understanding of casting and the mechanics of the tendons and the foot/ankle joints, clubfoot deformity is no longer disabling and patients who are appropriately treated such as your son can lead long and functional pain free lives. In regards to your question, it is not uncommon for parents to note a slight delay in walking age in patients who are treated with serial casting for clubfeet. The delay is often related to the underlying length of casting treatment. The ability to walk comes from the developing brain and not the feet themselves. As pediatric orthopaedists, it is our job to make sure that the limbs/feet are in the proper position to aid the ability to walk when the developing brain is ready. Although casting may delay this timing, the majority of children treated for clubfeet who have otherwise normal brain development will catch up to their peers at an appropriate time. As long as your child walks independently by 18 months of age, I would not worry too much. Continue to focus on encouraging your child to stand and take steps with assistance and soon they will walk on their own, often when you least expect it!

- Sadiya - India (Parent)