EPWORTH, Iowa — In honor of World Clubfoot Day, commemorated each year in June, Lauren Kronlage, 9; her brother, Owen, 3; and their cousin, Natalie Bonert, 6, asked friends, family, neighbors and even a local business to donate to their fundraiser for Clubfoot Solutions, an organization that provides braces and shoes to children who have the foot deformity.
Clubfoot is a congenital deformity that affects the bones, muscles, blood vessels and tendons of the foot. The front half of the foot turns inward and the heal points down. In very serious cases, the foot is turned in so far that the bottom faces sideways or up rather than down.
Lauren and Owen, of Epworth, and Natalie, of Colesburg, had a good reason to want to help the Coralville nonprofit — they all were born with clubfoot.
Julie Kronlage, mother of Lauren and Owen, said they have come to the realization that clubfoot, as well as cleft palate, is a genetic trait in the family.
“I knew there was cleft palate in the family, so we wanted to check for that because we knew it skipped every other generation,” Julie said. “When they looked at Lauren when she was in utero, they didn’t see cleft palate, but they said, ‘Oh, she’s got clubfoot.’ I said, ‘What is clubfoot? Never heard of it.’”
Julie has educated herself on clubfoot and is a fierce advocate for her children and for helping guide other parents, including her sister-in-law and Natalie’s mother, Megan Bonert.
Megan, who is married to Julie’s brother, Jeff, was unprepared when Natalie was born at 35 weeks with one clubfoot. Scans hadn’t picked it up prior to the birth. But she had an immediate contact and confidant in her sister-in-law.
“Julie had already gone through this with Lauren,” Megan said. Her older child, Mason, 9, had been been born without any issues. “I didn’t even have to call her. She just showed up. She got me to the first appointment. She prepared me and said ‘This is going to be hard.’ So she already knew the process. She was always just a phone call away.”
Julie and Megan set out on a mission to research their family histories, sifting through family Bibles and papers and talking to living family members.
“No one wrote anything down,” Julie said. “It wasn’t something anybody in the family talked about. But we’ve been able to verify 13 family members who were born with clubfoot, and some with cleft palate, back through several generations.”
Julie said clubfoot runs on the maternal side of both her family and her husband Scott’s family.
Scott was born with clubfeet and wore uncomfortable and heavy, hard, high-top shoes during much of his childhood to correct them.
“I don’t remember much about that,” he said. “So, I’m pretty sure it wasn’t fun.”
“The family had no trouble talking about the cleft palates in the family,” Julie said. “But clubfoot just wasn’t mentioned.
After that, we learned about all of the other cases (in the family). We pretty much knew then that any kid that Scott and I had were going to probably end up with clubfeet.”
Julie and Megan took their newborns to the Ponseti Clubfoot Center at University of Iowa Stead Family Children’s Hospital. The center was founded by Dr. Ignacio Ponseti, a Spanish-American physician who created the Ponseti method of correcting clubfoot in the 1950s. He came to U of I as a physician and member of the faculty in 1944.
Ponseti, who treated orthopedic injuries of soldiers during the Spanish Civil War as a military medic, developed a nonsurgical method of manipulating the foot, followed by a series of casts and a brace, to correct clubfoot. Prior to the Ponseti method, people with clubfoot simply learned to live with it, adapting by walking on their ankles or the sides of their feet.
Starting when each child was just a few weeks old, Julie and Megan made the trek to Iowa City every five days to have their children’s feet casted and re-casted. Natalie, who was born early, began the process when she was a few months old due to her smaller size.
At the last casting — usually the eighth or ninth — the Achilles tendon is cut, which allows the tendon to be overstretched. Once the tendon heals, the foot becomes more flexible. When that cast is removed, a brace is worn to “teach” the feet to stay in place. Eventually, the brace is only worn during sleeping hours, and then is not worn at all.
Dr. Jose Morcuende, a pediatric orthopedic surgeon at Stead, was the treating physician for the Kronlage and Bonert children.
Lauren and Natalie stopped wearing their braces at age 5. Owen wears his, but his mother expects he will stop wearing it around the same age.
Lauren, unlike most children with clubfeet, did have to undergo surgery when she was 7 for a double tendon transfer. Most children with clubfeet don’t undergo any surgeries.
The children run and play as much as others their age. Their clubfeet are no longer an issue thanks to Ponseti’s method, Morcuende’s medical care and the diligence and dedication of their parents. Lauren plays softball. And all three love to jump on trampolines.
Morcuende founded Clubfoot Solutions, which provides the Iowa brace to children in developing countries. Morcuende created the brace to perfectly complement the Ponseti method.
Lauren, Owen and Natalie raised $2,735 for the nonprofit, which will help eighty children in developing countries get shoes and an Iowa brace to help correct their clubfoot.
“They are amazing kiddos,” Julie said.