Foot & AnkleBirth
Congenital Talipes Equinovarus (Clubfoot)
A congenital deformity with cavus, adductus, varus, and equinus (CAVE) of the foot, treated primarily with the Ponseti method.
Presentation
- Rigid foot with hindfoot equinus and varus, forefoot adductus
- May be idiopathic or syndromic/neurologic
Imaging & Workup
- Diagnosis is clinical; radiographs reserved for complex or relapsed cases
Treatment
Ponseti casting
Serial manipulation and casting correcting CAVE in sequence.
Achilles tenotomy
Percutaneous for residual equinus in most cases.
Bracing
Foot abduction orthosis to prevent relapse — adherence is key.
Clinical Pearls
- Cavus is corrected first by supinating the forefoot
- Relapse is usually due to brace non-compliance