Talipes Equinovarus

Question 1

Talipes Equinovarus Definition

Answer 1

-Congenital orthopaedic condition
-Foot excessively turned (equinovarus) with a high medial longitudinal arch (cavus)
Either positional or congenital
-Positional is normal foot held in deformed position in uterus, correctable with gentle passive dorsiflexion, five times more common than positional
-Congenital is a fixed condition which can be idiopathic or teratological
-Idiopathic type usually isolated skeletal anomaly, usually bilateral
-Non idiopathic type caused by genetic syndromes, teratological anomalies etx.

Question 2

Talipes Equinovarus Associations

Answer 2

• 20% of cases associated with other genetic and congenital conditions
• Spina bifida, CP, arthrogyroposis

Question 3

Talipes Equinovarus Presentation

Answer 3

• Mild to extremely rigid foot
• Heel high with fibula prominent
• Calf muscle and foot are typically smaller than normal

Question 4

Talipes Equinovarus Ix

Answer 4

-Diagnosis is clinical but imaging is helpful

Question 5

Talipes Equinovarus Management

Answer 5

• Ponseti method is gold standard
  
  • Foot repositioned and cast applied, repeat. Eventually achilles tenotomy
• French functional method
  
  • easiest for young children
  • foot gradually stretched and held in place with tape