Ortho - Talipes

Question 1

What are talipes?

Answer 1

Fixed abnormal ankle position present at birth

AKA clubfoot

Can occur spontaneously or associated with other syndromes

Question 2

What are the different position of talipes?

Answer 2

Talipes equinovarus
Ankle in plantar flexion and supination

Talipes calcaneovalgus
Ankle in dorsiflexion and pronation

Question 3

How is talipes treated?

Answer 3

Ponseti method

Surgery if ponseti method fails or cannot be used

Question 4

What is the Ponseti method?

Answer 4

Treating talipes without surgery, very successful

Treatment started immediately after birth

Foot manipulated towards normal position and cast applied to hold it in position

Repeated several times until foot in correct position

Achilles tenotomy to release tension in achilles performed to release tension often in clinic

After treatment cast finished with a brace to hold feet in correct position when not walking until child is 4 years old

Brace aka boots and bars

Question 5

What is positional talipes?

Answer 5

Resting position of ankle is in plantar flexion and supination, but not fixed in this position and no structural boney issue

Muscles are slightly tight around ankle, but bones unaffected, foot can be moved into normal position

Needs physiotherapy, resolves with time