Orthotic Management Of Club Feet Course


Clubfoot describes a range of foot abnormalities usually present at birth (congenital) in which a baby’s foot is twisted out of shape or position. In clubfoot, the tissues connecting the muscles to the bone (tendons) are shorter than usual. Clubfoot is a fairly common birth defect and is usually an isolated problem for an otherwise healthy newborn. Clubfoot can be mild or severe. About 50% of children with club feet have it on both feet. The most common features of clubfoot are described as follows:

  • the top of the foot is usually twisted downward and inward, increasing the medial longitudinal arch and turning the heel inward.
  • the foot may be turned so severely that it actually looks as if it is upside down.
  • the affected leg or foot may be slightly shorter.
  • the calf muscles in the affected leg are usually underdeveloped.

The incidence of congenital idiopathic clubfoot in the USA in 2002 was 1/1000; in the Netherlands during 2013 and 2014 was 1.09/1000 live births, in Australia (Caucasian) was 1.11; in Sweden was 1.4/1000 live birth; in Belgium 1.6/1000 live birth and Australia (Aboriginal) 3.49/1000 live birth. 

In reference to Critical Incidence Analysis (CIA) fact book statistics, it was estimated that in China clubfoot incidence was 1.2/1000 live births; in Mexico, clubfoot incidence was 1.2/1000 live births; in Cambodia, clubfoot incidence was 1.2/1000 live births and in Tanzania was 1.2/1000 live births.

Despite effective treatments, children in low-income countries (LMICs) face many barriers such as limited access to equipment (specifically casting materials and abduction orthoses/braces), shortages of healthcare professionals, and low education levels and socioeconomic status amongst caregivers and families. These factors make it difficult to detect and diagnose children with clubfoot, connect them to care and train their caregivers to follow the proper treatment, and return for follow-up visits. In an effort to reduce the burden of clubfoot in LMICs, there have been initiatives to improve early diagnosis, organize high-volume Ponseti casting and bracing, update and upgrade the skills of practitioners, engage families in care, and insight into the need for local follow-up in the person’s community.

Course Aim

This course is designed to equip the trainee with the knowledge and skills carry out serial casting, manipulate the foot to limit functional and fixed contractures, fabricate and fit a brace/orthosis independently

Course Objectives

To train participants on designing concepts, principles and methods of Serial Casting for a Club Foot, Ankle Foot Orthosis (AFO) or Brace and its application to a Club Foot Client (CFC)

Learning Outcomes

  1. Cary out visual and physical assessment for a CFC
  2. Demonstrate Manipulation of  correcting and re-aligning a Club Foot Deformity (CFD)
  3. Demonstrate Serial Casting of a CFD 
  4. Demonstrate an understanding of measurement transfer of a negative cast for an Ankle Foot Orthosis (AFO) or Ponseti Brace
  5. Design an image of AFO or Ponseti Brace on a negative cast viewed from both frontal, transverse and sagittal plane
  6. Rectify an AFO or Ponseti Brace positive cast
  7. Demonstrate the moulding/lamination process of an AFO or Ponseti Brace
  8. Fit an AFO or Ponseti Brace
  9. Analyze the fitting of an AFO or Ponseti Brace

Expected competence after taking the course

  1. Acquire knowledge and skills in fabricating an AFO and Ponseti Brace
  2. Assess static and dynamic changes achieved as compared to the initial status without an AFO or Ponseti Brace
  3. Analyze structural and functional quality achieved when an AFO or Ponseti Brace is assembled following a contemporary or hybrid technology

Credits: 35.6

Instructional Methods

The course will be in English and is a Blended Learning Course whereby students will be attending scheduled lectures online and there will be PowerPoint presentations, notes of the session, quizzes and video presentations for a step-by-step demonstration of carrying out specific clinical and practical procedures. The participants will come to the college for the first and last week of face-face practical sessions.

Who can Apply:

This course is for Prosthetists/Orthotist working in different Prosthetics & Orthotics Centres/departments within and outside the country. It is also for all those who are working in private centres supported by religious organizations or NGOs. All those who will be eligible for the course must at least have their Desktops or Laptops Computers.

Dates and duration:              THREE MONTHS (3)

Hours:                                    355.5 Hrs for three months

Place:                                      KCMUCo

Course Fees                           1,900,000/=

This fee will cover the cost of course material, which will be made available to all participants during presentations of individual sessions. Also, it will be used to purchase consumables required for the fabrication of AFO and Ponseti Brace during the two weeks face-face workshop.


This course has been organized by KCMUCo, Department of Prosthetics & Orthotics, Faculty of Rehabilitation Medicine and Umweltzentrum (UWZ)

Coordinator of Short Courses: Ms A. Menuka