Talipes

Alternative names
Talipes equinovarus; Clubfoot

Definition
A clubfoot is a foot disorder where the foot turns inward and downward at birth (and remains tight in this position, resisting realignment).

Causes, incidence, and risk factors

Clubfoot is the most common disorder of the legs that children are born with. It can range from mild and flexible to severe and rigid.

The cause is not known, but the condition may be inherited. Risk factors include a family history of the disorder and being male. It occurs in about 1 per 1,000 live births.

Symptoms

The physical appearance may vary.

     
  • One or both feet may be affected  
  • The foot turns inward and downward at birth (resisting realignment)  
  • The calf muscle may be smaller than normal and underdeveloped

Signs and tests

The disorder is identified during a physical examination. A foot X-ray may be performed.

Treatment

A clubfoot can be treated by manipulating the foot into a correct position, and casting the foot to maintain the position. This is often done by an orthopedic specialist. The procedure should be started as early as possible - ideally, just after birth when the foot is easiest to reshape.

Repositioning and recasting occurs every few weeks to improve the position of the foot. After the shape of the foot is realigned, it is maintained through exercise, splints at night, and orthopedic shoes. This approach takes about 3 months, although maintaining the correct foot position may require night-time braces or other treatment for years.

Some severe cases of clubfoot will require surgery if the manipulation process is not successful. Continued evaluation is recommended until the foot is fully grown.

Expectations (prognosis)
The outcome is usually good with treatment.

Complications

Some defects may not be totally correctable, but with treatment the appearance and function of the foot can be improved. The treatment may be less successful if the clubfoot is associated with other birth disorders.

Calling your health care provider

If your child is being treated for clubfoot, call your health care provider if swelling, bleeding, or change in color of the toes occurs under the cast, if the toes disappear into the cast, or if the foot begins to turn in again after treatment.

Johns Hopkins patient information

Last revised: December 8, 2012
by Brenda A. Kuper, M.D.

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