Cleft Foot

What Is Cleft Foot?

Cleft foot, also known as the split foot, is an autosomal dominant disorder with low penetrance that affects the structural integrity of the foot and, in turn, causes anomalies extending from the fingers present in the foot towards the ankle. It results from an underdeveloped foot region during the fetal development stage.

Among patients with the condition, the average age at the time of surgery is around 4 years (range, 5 months to 13 years) [1]. The prevalence of cleft foot or cleft hand is scarce, and its occurrence has been estimated to be around 1 in 90,000 live births [2].

The malformations caused in the cleft foot result from an increase in cell death or a decrease in cell proliferation caused due to genetic abnormalities.

Cleft Foot Symptoms

Individuals suffering from cleft foot experience the following symptoms:

  1. Individuals affected by cleft feet have a V-shaped foot with a few toes missing.
  2. Pain or difficulty during walking, running, standing and exercises that put force on the foot.
  3. The pain and discomfort caused due to cleft feet might increase from increased activity, specific postures or massage points that put pressure on the foot.
  4. At times, it could also be associated with certain deformities related to the hand structure.

When Do Your Feet Stop Growing?

Even though the structural development of feet occurs during fetal development, their size keeps growing as a child ages. An individual's feet stop growing near the age of early twenties or late teens, depending on the age of puberty. During this time, the growth plates harden which makes them similar to the other body parts which stops the production of new bone cells in the foot region by the body which in turn halts the process of growth in the foot region. The amount of foot growth during puberty depends on an individual's height and weight.

Types of Feet Shapes

The human foot comes in a lot of different shapes and sizes. However, common types of foot shapes are based on the size and shape of the foot. Egyptian feet also known as perfect feet is the type of foot shape wherein the first toe finger is the largest. Greek foot is a foot shape wherein the second foot finger is longer than all the other fingers. Roman feet are a foot shape wherein the first four toe fingers are aligned with having an almost similar length. A deep arch at the posterior region of the foot is known as a hollow foot whereas no arch at the same area is known as a flat foot.

Holes on the Bottom of the Feet (Structural Changes of Cleft Foot)

Muscles, bones, ligaments and tendons collectively support the foot structure. Each toenail is attached to the foot through metatarsal-phalangeal joints. The separation of each toenail and differences in its structure causes the foot to have tiny holes near the end or bottom of the foot in normal anatomy. A cleft foot causes budges towards the end of the foot and creates a huge hole-like void that has a V-shaped structure. 

Toes Split

A thick band of a ligament known as a plantar plate is situated across the toe joints, protects the bones in the toe region from heavy pressure, and separates the toe fingers. A tear or underdevelopment of the plantar plate causes the process that causes some toe fingers to merge, thereby creating an appearance of toes splitting thereby creating a V-shaped structure known as a cleft foot [3]. The missing toe fingers create a valley-like structure that seems like there has been a split between the toe fingers present at each side of the toe. 

Cleft Foot Diagnosis and Treatment Options

Cleft foot consists of a specific type of foot deformity that causes the foot to have a V-shaped structure which could help physicians diagnose its occurrence. This deformity is visible after the birth and could also be visible for a fetus through imaging techniques like sonography or X-ray. As the event of the cleft foot is quite rare, no benchmark treatment methodologies are aiming to fix the cleft foot. Therefore, the study around the surgical procedures related to correcting foot deformities is limited to children, not adults. Even though surgical reconstruction procedures are the most reliable treatment option for cleft feet, it cannot entirely eradicate the vitality issues caused by the cleft foot [4]. Apart from that, stable fixation and dosed control could help in managing conditions caused due to the presence of cleft foot deformities.

A Cleft foot might cause a significant decline in the overall quality of life of an individual, and therefore, its management and treatment become pretty substantial. 

Cleft foot - References

  1. ^ Bryan Waxman et. al. (2022). Congenital-CleftFoot-Deformity-Treatment. Retrieved 12 Nov 2022.
  2. ^ Gane B. and Natarajan P. (2016). Split-hand/feet malformation: A rare syndrome. Journal of Family Medicine and Primary Care, 5(1): 168–169. Retrieved 12 Nov 2022.
  3. ^ Leonchuk A. et. al.(2020). Cleft foot: A case report and review of literature. World Journal of Orthopaedics, 11(2): 129–136. Retrieved 12 Nov 2022.
  4. ^ Yuko T. et. al. (2000). Surgical Treatment of the Cleft Foot. Journal of the American Society of Plastic Surgeons, 105(6). Surgical Treatment of the Cleft Foot. Retrieved 31 Oct 2022.