Clubfoot (Talipes Equinovarus)
What is Clubfoot (Talipes Equinovarus)?
Clubfoot (Talipes Equinovarus) Definition
Talipes Equinovarus, or Clubfoot, is a congenital deformity affecting the major structures of the foot, including: bones, muscles and skin. It's defined by the classic inward deviation of the affected foot/feet, at birth. It occurs twice more commonly in boys than girls, and in roughly 1 in 1000 births. This can occur in a single foot, but can be bilateral in 50% of the cases. Clubfoot can be diagnosed on prenatal ultrasound or at birth.
Clubfoot (Talipes Equinovarus) Symptoms and Anatomy
Clubfoot typically involves a significant bend of the ankle inward, with corresponding tight muscles along the inside of the foot and ankle, as well as the Achilles tendon. The leg on the affected side tends to be shorter. The calf muscles on the affected side tend to be smaller. The foot itself tends to be smaller and wider. As a result of the above, the affected foot can form a 90 degree angle relative the lower leg. The great toe is often deviated inward as well.
Clubfoot (Talipes Equinovarus) Treatment Options
The primary goal of treatment is to provide an aligned foot that will encourage proper bone growth and muscle function. The foot deformity is typically corrected via an ordered set of soft casts/braces, during the first 6 months of life, and continuing thereafter into the toddler stage, as needed. This treatment is successful for many children.
However, if bracing/serial casting is ineffective, surgery may be recommended.
Clubfoot (Talipes Equinovarus) Surgery
Surgery is reserved for children that have persistent foot deformity despite serial casting/bracing. Depending on the amount of residual deformity, the foot and ankle can be reconstructed, to allow for appropriate positioning and growth of the foot and ankle structures. This typically involves relaxing the Achilles tendon along with other tendon reconstructions and potentially bony cuts.