Congenital clubfoot is a developmental malformation that can be detected at birth. Clubfoot can occur in one or both feet. During pregnancy, a normally developing foot transforms into a clubfoot, which is characterized by thick and tight medial posterior tendons and ligaments and shorter than normal muscle development. As a result of this transformation, the posterior and medial portions of the foot are pulled together, causing the foot to twist downward and inward. The bones of the foot are thus in an abnormal position. The foot turns over, stiffens, and the child is unable to place the foot in its normal position in the usual way. The following is a general procedure for the treatment of congenital clubfoot in small infants and children. If your child is older or has other health problems in addition to clubfoot, the treatment plan will be different. 1. Manipulation and cast orthopedic treatment After several weeks of manipulation, the bones are reset to their normal position so that the deformity of the foot is gradually corrected. After each manipulation, the foot and leg are put in a cast and kept for 5-7 days to keep the foot in position and to allow the tight ligaments, joint capsule and tendons to stretch and elongate. This procedure is done approximately 4-6 times. Severe horseshoe foot should be put into a cast several more times. In most cases, the Achilles tendon will be severed to complete the orthosis. The procedure is performed under local anesthesia and takes only a few minutes. The Achilles tendon will repair itself and the foot will be dorsiflexed enough by the Achilles tendon severance. The foot and leg are again put in a cast and kept for 3 weeks. 3. Use of a brace to maintain orthosis After the last cast is removed, the child’s foot is placed in a brace. The brace is worn continuously for 3 months, 23 hours a day. After 3 months, and after a period of time, the brace is worn for a shorter period of time. Finally, the child will wear the brace only at night (12-14 hours per day) until the age of 4-5 years. The brace is a key part of the treatment. Even though your child’s foot looks normal, there is a risk of a recurrence if your child does not wear a brace. By the time your child reaches the age of 7, recurrences are rare. 4. Physical therapy Different treatments help maintain the correction and support your child’s development. Parents personally give their child traction and other treatments as directed by their doctor or therapist. Guidance and helpful suggestions for the cast phase Bring something for the child to eat or drink each time they come in for a cast change, such as a bottle, favorite toy or book to distract them during the cast.