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There are several theories as to the cause of clubfoot. A familial tendency or arrested growth during fetal life may contribute to its development, or it may be caused by a defect in the ovum. It sometimes accompanies meningomyelocele as a result of paralysis. In mild clubfoot there are slight changes in the structure of the foot; more severe cases involve orthopedic deformities of both the foot and leg. Although clubfoot is usually congenital, an occasional case in an older child may be caused by injury or poliomyelitis.
Treatment varies according to the severity of the deformity. Milder cases may be corrected with casts that are changed periodically, the foot being manipulated into position each time the cast is changed so that it gradually assumes normal position. A specially designed splint may also be used, made of two plates attached to shoes with a crossbar between the plates and special set screws so that the angulation of the foot can be changed as necessary. More severe deformities require surgery of the tendons and bones, followed by the application of a cast to maintain proper position of the joint.
talipes/tal·i·pes/ (tal´ĭ-pēz) a congenital deformity in which the foot is twisted out of shape or position; it may be in dorsiflexion (t. calca´neus), in plantar flexion (t. equi´nus), abducted and everted (t. val´gus or flatfoot), abducted and inverted (t. va´rus), or various combinations (t. calcaneoval´gus, t. calcaneova´rus, t. equinoval´gus, or t. equinova´rus) .
talipesLatin, talipes = talus–ankle + pes–foot A general term for clubfoot–a congenital foot deformity involving the talus. See Clubfoot.
talipesClubfoot. A congenital deformity affecting the shape or position of one or both feet. In talipes cavus, there is exaggeration of the curvature of the longitudinal arch. In talipes equinovarus the ankle is extended and the heel and sole turned inwards.
talipescongenital foot deformity, about the talus
talipes calcaneovalgus congenital vertical orientation of longitudinal axes of talus and calcaneum secondary to soft-tissue deformity of lower leg and foot; characterized by marked ankle joint dorsiflexion, subtalar joint eversion, loss of concavity of medial longitudinal arch; the foot cannot be placed passively in a plantigrade position
talipes equinovarus significant congenital skeletomuscular deformity of lower limb and foot; absence of pronatory rotation at neck of talus causes the foot to retain the early embryological relationship to the lower limb (Figure 1); occurs ideopathically, but is also associated with significant congenital neurological dysfunction/dysplasias; characterized by heel inversion + very marked forefoot inversion, underdevelopment and contracture of lower-limb posterior musculature, ankle plantarflexion, near horizontal talar axis, marked inversion of subtalar and midtarsal joints, forefoot adduction, weight-bearing lateral rearfoot, talar head prominence at dorsolateral aspect of rearfoot, exaggerated concavity of medial longitudinal arch exaggerated, and inability to place the foot passively in plantigrade position; treatment aims to achieve a plantigrade foot, e.g. early-infancy strapping and soft-tissue stretching (a Denis Browne splint may be used to maintain correction gained by strapping/stretching therapy, once the child can walk); reduction of persistent soft-tissue contractures with injection of botulinum toxin into posterior-group muscles (+ below-knee cast); surgical options include Achilles tendon lengthening, or plantar fasciotomy; skeletal deformity/dysfunction is corrected by osteotomy (e.g. of calcaneum and metatarsals) and/or triple arthrodesis in order to achieve a plantigrade and functional foot