Talipes Equinovarus (Club foot)

Background

  • Inverted and plater flexed deformity of the foot/ankle, usually diagnosed at the newborn exam
  • Occurs in around 1 in 1000 and twice as common in males
    • Around 50% are bilateral

Causes

  • Usually idiopathic
  • Associated with
    • Spina bifida; cerebral palsy; Edward’s syndrome (trisomy 18); oligohydramnios; arthrogryposis (multiple joint contractures at birth)

Diagnosis/Investigation

  • Often clinical (rarely investigated further)

Management

  • Ponseti method
    • Manipulation/progressive casting starting as soon as possible once the diagnosis has been made (within weeks of birth)
    • Usually successful after 6-10 weeks
  • Patients may require Achilles tenotomy following this
  • Night time braces can also be used up until the child is of school age
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