Case Studies on Detection and Follow-up in NBBD network SWACH and NHM


Female child was born after 40 weeks of gestation to a 22 years old woman at RIMARY Health Center (PHC) in Naharpur, Haryana, by normal vaginal delivery conducted at PHC by doctor. The baby weighed 3000 grams at the time of birth. It was detected at birth as a visible birth defect due to the typical appearance of a baby’s right foot which was turned inwards.


The foot had a typical presentation. Their foot was pointing downwards at their ankle (aka position equinus), the heel of the right foot was turned inwards (aka position varus). The middle section of the foot was twisted inwards but the foot did not appear very short or wide. It stayed in this position and could not be moved into a normal foot position. There were no other associated birth defects.


Photographs of the defect were submitted and full description was confirmed by WHO-SEARO to be:-

Q65-Q79 Congenital malformations and deformations of the musculoskeletal system

Q66.0 Talipes equinovarus

Talipes equinovarus is also commonly known as club foot. The diagnosis of clubfoot can be noted during a prenatal ultrasound, however, the severity of it cannot be determined until after the child is examined and there is no treatment until after the child is born

Treatment & Follow-up

It is important in a case like this that the baby be referred to see a doctor specialized in treating this problem as soon as possible after birth.┬áHere the child was referred and attended by an orthopedic; who assessed the case (holds, stretches and moves) the child’s foot with their hands into a position whereby deformity was put right (corrected) as much as possible. This is typically not painful or uncomfortable for the child.

Once in this position, a plaster cast was put on to hold the child’s foot in position, shown here. After around six weeks of repeated manipulation and plaster casting of the foot, progress was monitored. She was given exclusive breast feeding. According to the family there is improvement. The child weighs 3900 grams at the age of 6 weeks. The head size is normal.