Prevalence:

• 1 in 1,000 births.
• Bilateral in 50% of cases.

Ultrasound diagnosis:

• Demonstration that the sole of the foot is not perpendicular to the lower leg bones.

Associated abnormalities:

• In >50% of cases the condition is isolated.
• Chromosomal abnormalities: common finding in trisomies 18 and 13.
• Commonly associated with prolonged oligohydramnios, brain abnormalities, spina bifida, skeletal and neuromuscular disorders.
• More than 250 genetic syndromes include clubfoot as one component.

Investigations:

• Detailed ultrasound examination.
• Non-isolated cases: invasive testing and array.

Follow up:

• Isolated: standard follow-up.

Delivery:

• Standard obstetric care and delivery.

Prognosis:

• Isolated: good prognosis.
• In 90% of cases good long-term function is achieved by manipulation and serial application of casts, supported by limited operative intervention.
• Surgery is necessary in about 10% of cases and in one third more than one operation is needed.

Recurrence:

• One sibling with clubfoot: 3%.
• Parent and one child with clubfoot: 25%.