Talipes

Question 1

What is talipes?

Answer 1

Talipes equinovarus aka club foot = inverted (inward turning) and plantar flexed foot. It is usually diagnosed on the newborn exam.

They can be fixed or positional deformity of the foot/ankle.

2 types:
=> Talipes Varus (r = reaching)
=> Talipes Valgus (l = leaving)

Question 2

Who does talipes affect?

Answer 2

Males > Females [2:1]

~50% cases are bilateral

Question 3

What is the cause of talipes?

Answer 3

Most commonly idiopathic

Associations include:
=> Spina bifida
=> Cerebral palsy
=> Edward's syndrome (trisomy 18)
=> Oligohyramnios
=> Arthrogrposis

Question 4

What is the management for fixed talipes?

Answer 4

Ponseti method:
manipulation and progressive casting which starts soon after birth.

The deformity is usually corrected after 6-10 weeks.

An Achilles tenotomy is required in around 85% of cases but this can usually be done under local anaesthetic.

Night-time braces should be applied until the child is aged 4 years. The relapse rate is 15%