Talipes equinovarus: two case reports and literature review.
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Clubfoot, or talipes equinovarus, was introduced into the medical literature by Hippocrates in 400 B.C. The clubfoot deformity is a pathologic condition consisting of inversion and adduction of the forefoot, equinus of the ankle, and inversion of the heel. The condition has also been described as a congenital subluxation of the talocalcaneonavicular joints. This manuscript will review the literature with respect to history, incidence, etiology, anatomy, classification, radiology, and treatment. Two case reports are also presented.Keywords:
Subluxation
Etiology
Congenital talipes equinovarus
Medical literature
Foot (prosody)
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Clubfoot, or talipes equinovarus, was introduced into the medical literature by Hippocrates in 400 B.C. The clubfoot deformity is a pathologic condition consisting of inversion and adduction of the forefoot, equinus of the ankle, and inversion of the heel. The condition has also been described as a congenital subluxation of the talocalcaneonavicular joints. This manuscript will review the literature with respect to history, incidence, etiology, anatomy, classification, radiology, and treatment. Two case reports are also presented.
Subluxation
Etiology
Congenital talipes equinovarus
Medical literature
Foot (prosody)
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Abstract: Congenital idiopathic clubfoot is a deformity typically occurring in an otherwise healthy child which occurs in 11,4 in 10.000 live births. Approximately one-half of cases present with bilateral deformity and affects boys and girls equally. Clubfoot is characterized by adduction, supination and cavus deformity of the forefoot and midfoot, varus of the heel, and a fixed plantar flexion (equinus) of the ankle. Treatment od idiopathic type of clubfoot consists of corrective manipulation and casting by the Ponseti method, where usually four to six casts are needed. Equinus is corrected with tendo Achillis tenotomy followed by foot abduction brace application. Complex type of clubfoot, which has more severe rigid deformation, is present in 6,5% of all clubfeet and is refractory to the usual corrective manipulation and casting by the Ponsetti method. Clinically, complex clubfoot is characterized as short, stubby foot, having rigid equinus, severe adduction and plantar flexion of all metatarsals, a deep crease above the heel and a transverse crease in the sole of the foot. Modified Ponsetti method for treatment of complex clubfoot consists of simultaneus correction of adduction and heel varus and subsequent cavus and rigid equinus correction. After the Achillis tendon tenotomy, modified foot abduction brace is applied, where foot is in 40° outer rotation in contrast to 70° abduction used in less rigid congenital idiopathic clubfoot. Relapse occurs in 14% and is ussually related to problems with shoe fit and patient coplience.
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Congenital talipes equinovarus
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ABSTRACT Clubfoot is a birth defect that is marked primarily by a deformed talus (ie, ankle) and calcaneous (ie, heel) that give the foot a characteristic “club‐like” appearance. In congenital idiopathic clubfoot (ie, talipes equinovarus), the infant's foot points downward (ie, equinus) and turns inward (ie, varus), while the forefoot curls toward the heel (ie, adduction). This congenital disorder has an incidence of 1 in 400 live births, with boys affected twice as often as girls. Unilateral clubfoot is somewhat more common than bilateral clubfoot and may occur as an isolated defect or in association with other disorders (eg, chromosomal aberrations, cerebral palsy, spina bifida, arthrogryposis). Infantile clubfoot deformity is painless and is correctable with early diagnosis and prompt treatment. AORN J 61 (March 1995) 492–506.
Congenital talipes equinovarus
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Congenital club foot is the most frequent foot deformity. It occurs in 1% of newborns, two times more frequently in boys, with family inheritance. Patoanatomicaly, entity consists of bone deformities, articular malpositions and soft tissues retraction. All these produce adduction of the forefoot and varus and equinovarus of the hindfoot. Lateral side of the foot is convex and medial side is concave. Forefoot is in adduction and plantar flexion in relation to the hindfoot. The heel is rotated medially which induces varus and eqinus of the foot. The aim of the treatment is to establish anatomically normal foot, painless, with moderate movements, which is suitable for normal shoes. At the beginning treatment is nonsurgical. If nonsurgical treatment fails further step should be surgical treatment. The success of treatment of congenital clubfoot depends on the time of diagnosis and treatment beginning.
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Major foot deformities were analyzed using standardized radiographic drawings of the foot in weight-bearing. Specific criteria and a classification of foot deformities by radiographic analysis are presented, utilizing "lining systems" related to the main bones of the hindfoot.The radiographic appearance of the foot is described and analyzed, as are the principal deformities such as varus and valgus heel and forefoot. The prefixes "talipes" and "pes" have been used to signify congenital and acquired deformities, respectively.Specific foot deformities, including talipes equinovarus (clubfoot), pes planovalgus (flatfoot), pes cavus, and metatarsus varus, are analyzed. This method can also be applied in the radiological analysis of any foot deformity.By using this technique, a brief, concise and simplified analysis of foot deformities is available to the student, general practitioner, and specialist.
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Background and objective: Talipes Equinovarus (TEV) or Congenital Clubfoot is the most common congenital anomaly of the foot. The incidence of TEV is 1-2 per 1000 life births, about 30% of these cases is bilateral with a higher incidence in males than in females (2:1). Congenital Clubfoot is a complex deformity which has four components: Heel in equinus, hind foot in varus, mid foot in cavus, forefoot in adduction and supination. The presented study aimed to evaluate the surgical treatment outcome of congenital club foot by a modified soft tissue release (i.e. division of tendons of tibialis posterior and flexor hallucis longus). Methods: This is a prospective study done on the Result of treatment of congenital Clubfoot by soft tissue release. Numbers of patients are thirty three patients, forty eight feet, fifteen patients (45.46%) had bilateral, and eighteen patients (54.55%) had unilateral deformities. Twenty one patients (63.64) were male and twelve patients (36.37) were female, male to female ratio was 1.75:1, their ages range between 4-35 months (mean ages in months = 15.43 months). The patients whom included in this study had no previous treatment because of delay in presentation. Results: All patients were assessed clinically and radiologically. The result of our study was as follow: Excellent result for 28 feet (58.3%), Good result for 16 feet (33.3%), Poor result for 4 feet (8.3%). The over all result can be sub divided to two categories; a) satisfactory which involve both the excellent result and the good result (91.67%) and b) unsatisfactory result which involve only the poor result (8.33%). Conclusion: The study revealed that the use of this surgical method is of good result and lower rate of complication.
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AIM: The study aims to get acquainted with the morphogenetic features of the foot-binding deformity still remaining in China nowadays and its changes.METHODS: The investigation was carried out in Shandong province,Yunnan province,Fujian province and Shaanxi province with altogether 241 women,aging from 69 to100(80 at average),whose feet have ever been bound.Photos of their feet were taken and the length and width of the feet were examined to describe the morphogenetic features of the foot-binding deformity.RESULTS: The investigated foot-binding deformity were divided into 2 types: Talipes Calcaneus type and Talipes Equinus type.The foot-binding deformity of the women living in Shandong province,Yunnan province and Shaanxi province belonged to the Talipes Calcaneus type while that of the women living in Fujian province belonged to the Talipes Equinus type.Talipes Calcaneus type was characterized by the features of big heel,small forefoot and high instep with the2 nd,3 rd,4 th and5th toes curled towards the sole of the feet.In this type,women usually walked with Talipes Calcaneus steps.Talipes Equinus type was characterized by the features of small heel,big forefoot and high instep and the flat of forefoot was usually lower than that of the heel in the shape of echelon.In this type,women walked with Talipes Equinus steps.Besides,the length and width of the feet was obviously narrower than that of the women whose feet haven't been bound.CONCLUSION: The remaining foot-binding deformity in China now can be divided into two types,namely,Talipes Calcaneus type and Talipes Equinus type,according to the morphogenetic features of the talipes.Different ways of foot-binding can result in different morphogenetic features of deformity.Additionally,the length and width of the feet of the women whose feet have been bound are obviously narrower than that of the women whose feet haven't been bound.
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Clubfoot or talipes equinovarus is a complex deformity characterized by three distinct manifestations. The foot is in an equinus position; the forefoot and heel are in varus; and the entire foot is supinated. While the exact etiology of this problem remains unknown, many advancements have been made in the treatment of clubfeet. The surgical procedure is progressive and tailored according the severity of the deformity. Pain management, thorough neurovascular assessments, and education of the family are essential to caring for these patients.
Neurovascular bundle
Etiology
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Congenital talipes equinovarus
Ponseti Method
Foot deformity
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Congenital talipes equinovarus
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Foot deformity
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