Clubfoot is a congenital condition, meaning it is present at birth, where one or both feet are turned inward and downward. The exact cause of clubfoot is not fully known but is believed to be due to a combination of genetic and environmental factors. It tends to run in families, indicating a genetic predisposition, and may also be influenced by factors such as the position of the baby in the uterus, abnormal tendon and muscle development, less amniotic fluid, or exposure to harmful substances during pregnancy. Specifically, clubfoot is caused by a dysfunction involving the muscles, tendons, and ligaments in the lower leg and foot that leads to shortening and tightening of these tissues, resulting in the foot turning inward and downward. This includes abnormalities in the collagen synthesis and fibrosis in the foot structures during fetal development. It is more common in boys and sometimes occurs with other conditions like spina bifida or genetic syndromes such as trisomy 18. Environmental risks during pregnancy include smoking, infections like Zika, and oligohydramnios (low amniotic fluid). In summary, clubfoot arises from a complex interplay of genetics and environmental influences affecting the normal development of the foot and lower leg tendons, muscles, and ligaments during pregnancy.
