Talipes calcaneovalgus is a foot deformity encountered fairly frequently in neonates. Its incidence is around 4 cases per 10,000 newborns [1], but less severe cases may occur as frequently as in 5% of newborns [2]. Girls are affected more frequently than boys, and the condition can appear in one leg or both [3]. Predisposing factors are being a first-born, and breach delivery [1]. Together with irregularities in the digits, vertical talus, clubfoot, and metatarsus adductus, it represents the most prevalent foot problem apparent in the examination of the newborn.

The nomenclature of the foot deformities is somewhat ambiguous. The term clubfoot is used by some as the equivalent of talipes equinovarus (the sensu stricto clubfoot, a condition with plantar flexion and other characteristics). Others describe ”clubfoot” as a group of irregularities that include talipes calcaneovalgus (with dorsal flexion) and metatarsus adductus (with forefoot involvement only), in addition to talipes equinovarus. Congenital talipes calcaneovalgus is categorized as a positional talipes because the deformity is determined by the position of the foot pressed against the wall of the uterus.

Talipes calcaneovalgus is characterized by dorsal flexion of the foot, sometimes to an extreme degree, such that the toes touch the anterior tibia. The foot cannot be plantar-flexed beyond 90 degrees, and often is flexed to less than 90 degrees. In addition, the calcaneus is rotated externally, the feet are everted, the Achilles tendon is stretched, and the muscles of the leg are taut [4]. The ‘up and out’ appearance of talipes calcaneovalgus is the opposite of the ‘down and in’ presentation of talipes equinovarus – i.e. clubfoot in the narrow sense. Hence the name “reverse clubfoot” occasionally emerges for talipes calcaneovalgus [5]. Talipes calcaneovalgus must be differentiated from congenital vertical talus [6].

• Disability

  Please enable JS and disable any ad blocker [pediatricsconsultantlive.com]

  Dr Teresa Pountney heads up a team of experienced practitioners who cover a range of conditions from those experienced by the typically developing child to those with disabilities and diseases. [books.google.com]

  It is characterized by prenatal and postnatal growth retardation, microcephaly, moderate to severe intellectual disability, and multiple major and minor malformations. [ncbi.nlm.nih.gov]

• Surgical Procedure

  609 Traditional Procedures for the Repair of Hallux Abducto Valgus 623 Surgical Procedures of the Hallux 639 Complications of Hallux Abducto Valgus Surgery 655 Hallux Limitus and Hallux Rigidus 679 Compound Deformities 713 PesCavus 761 Pathologic Pes [books.google.com]

  Treatment includes stretching and splinting, with minor surgical procedures to more extensive reconstructive surgery. 6 Enlarge Print Summary Table Condition Characteristics Congenital vertical talus Foot rigidly fixed in valgus rotation because of structural [aafp.org]

  The surgical procedure varies from patient to patient but generally involves releasing all joint capsule contractures, lengthening any shortened muscle-tendon units, and realigning the bones of the foot. [orthopaedicsone.com]

  The surgical procedure usually consists of releasing and lengthening the tight tendons/joint capsule of the foot. [ndri.com]

• Movement Disorder

  The authors advise careful evaluation for movement disorders if club foot is detected. This is certainly reasonable. They also advise "strong consideration of karyotype evaluation" when club foot is diagnosed. [fetalsono.com]

• Visual Impairment

  Disease progression is rapid, resulting in severe spasticity, progressive cognitive decline, and visual impairment. Many affected children do not survive beyond their first decade. Atypical NAD shows more phenotypic variability than INAD. [ncbi.nlm.nih.gov]

• Foot Deformity

  Yes 1 Exempt from POA reporting No The ICD code Q66 is used to code Foot deformity A foot deformity is a disorder of the foot that can be congenital or acquired. [icd.codes]

  Talipes calcaneovalgus is a foot deformity that is relatively commonly observed in newborns. It is characterized by dorsiflexion and a valgus position of the foot. [symptoma.com]

  […] a positional or structural foot deformity depending on severity and/or causality. [amp.pharm.mssm.edu]

• Foot Pain

  Claw foot Clubfoot Clubfoot repair Common peroneal nerve dysfunction Extremity x-ray Flat feet Foot pain Foot sprain - aftercare Foot, leg, and ankle swelling Hand or foot spasms High arch Leg or foot amputation Metatarsal fracture (acute) - aftercare [icdlist.com]

  Retained metatarsus adductus reportedly causes foot pain due to shoe fitting and wear problems, and also promotes hallux valgus development. [podiatrytoday.com]

• Joint Deformity

  In regard to joint deformities caused by contracture of muscles and capsule, one can achieve correction via methods including: repeated gentle manipulation stretching of the tight structures; cast immobilization of the joints in the position of correction [podiatrytoday.com]

  Ponseti Treatment of Rigid Residual Deformity in Congenital Clubfoot After Walking Age. J Bone Joint Surg Am. 2016 Oct 19. 98 (20):1706-1712. [Medline]. Hsu WK, Bhatia NN, Raskin A, Otsuka NY. [emedicine.medscape.com]

• Hip Dislocation

  Research of Congenital Talipes Calcaneovalgus has been linked to Congenital Clubfoot, Congenital Abnormality, Foot Deformities, Hip Dislocation, Congenital, Congenital Foot Deformity. [novusbio.com]

  Typically, the abnormality resolves spontaneously over a few months; however, stretching or splinting is sometimes needed for full resolution. 2 Because talipes calcaneovalgus is associated with congenital hip dislocation, particularly from breech delivery [aafp.org]

  Clubfoot may also be associated with other malformations such as cleft lip and palate, micrognathia, congenital heart disease, hip dislocation and inguinal hernia. [fetalsono.com]

• Myopathy

  […] jt forward Flexible Flatfoot Paralytic Disease- ft held in calcaneus bc anterior is overpowering posterior Neurological events • Cerebral issues • Spinal cord pathology-poliomyelitis • Peripheral nerve pathology (rare, if so is the sciatic) • Primary myopathy [quizlet.com]

  Causes of the non-idiopathic type include genetic syndromes, teratological anomalies, neurological disorders and myopathies. [patient.info]

• Abnormal Gait

  This abnormal gait can cause focal loading on a small area and can be painful. Clubfoot is detectable via prenatal ultrasound in the second trimester. [orthopaedicsone.com]

• Agitation

  […] can be useful Avoid tight baby gro's or leggings so that there is plenty of room for your baby to stretch their legs and feet Avoid wearing baby shoes and tight socks Stretches To be performed at every nappy change/ feed Do not stretch if your baby is agitated [gpnotebook.co.uk]

• Confusion

  This should not be confused with subcostal retraction in this premature infant who had respiratory distress. Figure 5.29. In this infant the chest appears to be narrow compared with the rest of the body. 5.30 Figure 5.30. [rrnursingschool.biz]

Foot deformities are discovered in the newborn by careful examination of both feet. Even the skin can reveal unusual tightness in cases of abnormality, but an important part of the examination is testing for the movements of the joints. In talipes calcaneovalgus, the plantarflexion is markedly limited; however, the dorsiflexion can, to some extent, be rectified by gently stretching the foot. In contrast, congenital vertical talus, which can be misdiagnosed for talipes calcaneovalgus, and which is characterized by a rigid bone dislocation, is not correctable.

Radiographs are used to verify the diagnosis and for differentiating talipes calcaneovalgus from congenital vertical talus. On lateral radiographs, the first metatarsal aligns with the talus bone in case of a talipes calcaneovalgus foot, whereas the axis of the talus is plantar to that of the first metatarsal in the congenital vertical talus condition.

TNJ and the heel is placed in ______ equinus, varus when do we use tarso-suspensory shoes or UCBL heel stabilzers for treatment after manipulative casting has been done memorize Pages linking here (main versions and versions by same user) [memorize.com]

3 Treatment of foot deformities? Need foot specialist: In general, treatment is either via splinting/ bracing, or surgical correction & repair. [healthtap.com]

Increase up to 1 minute if your baby remains relaxed Repeat 5 times Reference: Hart D: Variability in the Physiotherapy Treatment of Talipes Equinovarus, APCP Journal, June 2006 Mid Cheshire Hospitals NHS Foundation Trust. [gpnotebook.co.uk]

Similar articles [Congenital club foot: treatment in childhood, outcome and problems in adulthood]. Besse JL, Leemrijse T, Thémar-Noël C, Tourné Y; Association Française de Chirurgie du Pied. Besse JL, et al. [pubmed.ncbi.nlm.nih.gov]

Prognosis Excellent overall prognosis Improves spontaneously and rapidly Partial correction results in a Flexible Flatfoot VIII. Patient Resources IX. [fpnotebook.com]

Overall prognosis will often depend on other associated conditions. Isolated conditions may be treated successfully 8. [radiopaedia.org]

Prognosis The prognosis for successfully treating clubfoot is good at this time. Persons with clubfoot that is corrected by surgery may notice some increased stiffness in their affected feet as they age. [healthofchildren.com]

PMID: 3818770 Prognosis Faraj AA J Foot Ankle Surg 1995 May-Jun;34(3):319-21. doi: 10.1016/S1067-2516(09)80067-7. [ncbi.nlm.nih.gov]

Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. [icd10coded.com]

Etiology Results of positional confinement in utero IV. [fpnotebook.com]

Introduction: The most common form of spinal muscular atrophy (SMA) is a recessive disorder caused by SMN1 mutations in 5q13, whereas the genetic etiologies of non-5q SMA are very heterogenous and largely remain to be elucidated. [keio.pure.elsevier.com]

This paper is intended to provide an overview of the deformity of calcaneovalgus including a discussion of etiology, incidence, clinical and radiographic manifestations, differential diagnosis, and recommended treatment. [ncbi.nlm.nih.gov]

Epidemiology Most common neonatal foot deformity More common in females III. Etiology Results of positional confinement in utero IV. [fpnotebook.com]

Epidemiological study of congenital talipes calcaneovalgus. Braz J Med Biol Res. 1986;19:59–62. PubMed Google Scholar Pappas AM. Congenital posteromedial bowing of the tibia and fibula. J Pediatr Orthop. 1984;4:525–31. [link.springer.com]

Epidemiology Incidence mild form can occur in up to 40% of newborns estimated incidence of true deformity is 1 in 1,000 live births Demographics more common in females and first-born children Etiology Pathophysiology usually a positional deformity of [orthobullets.com]

CORR Prenatal polio-like condition; epidemiological evidence,seasonal variation. Parker SE, Mai CT, Strickland MJ, Olney RS, Rickard R, Marengo L, et al. Multistate study of the epidemiology of clubfoot. [emedicine.medscape.com]

About this book Introduction This volume describes the state-of-knowledge in the study of the relationships between mechanical loading states in tissues and common pathophysiologies related to increase in mass of adipose tissues and/or hyperglycemia which [link.springer.com]

Epidemiology Incidence mild form can occur in up to 40% of newborns estimated incidence of true deformity is 1 in 1,000 live births Demographics more common in females and first-born children Etiology Pathophysiology usually a positional deformity of [orthobullets.com]

Pathophysiology Various theories of the pathogenesis of clubfeet have been advanced, including the following: Arrest of fetal development in the fibular stage Defective cartilaginous anlage of the talus Neurogenic factors Retracting fibrosis Anomalous [emedicine.medscape.com]

Centers for Disease Control and Prevention Intersex [coding-pro.com]

Some birth defects can be prevented. Taking folic acid can help prevent some birth defects. Talk to your doctor about any medicines you take. Some medicines can cause serious birth defects. [icdlist.com]

Particular attention will be paid to identification of exposures which may be modified by preventive intervention. [grantome.com]

1. Nunes D, Dutra MG. Epidemiological study of congenital talipes calcaneovalgus. Braz J Med Biol Res. 1986;19(1):59-62.
2. Gore AI, Spencer JP. The Newborn Foot. Am Fam Physician. 2004;15;69(4):865-887.
3. Connors JF, Wernick E, Lowy LJ, Falcone J, Volpe RG. Guidelines for evaluation and management of five common podopediatric conditions. J Am Podiatr Med Assoc. 1998;88:206–222.
4. Trott AW. Children's foot problems. Orthop Clin North Am. 1982;13:641–654.
5. Edwards ER, Menelaus MB. Reverse club foot. Rigid and recalcitrant talipes calcaneovalgus. J Bone Joint Surg Br. 1987;69(2):330-334.
6. Harris EJ, Vanore JV, Thomas JL, et al. Clinical Practice Guideline Pediatric Flatfoot Panel. Diagnosis and Treatment of Pediatric Flatfoot. The Journal of foot and ankle surgery. 2004;43(6):341-370.