Introduction

Congenital clubfoot, or congenital talipes equinovarus, is characterized by a fixed, plantar-flexed, adducted, and inverted foot.  If untreated, congenital clubfoot can result in severe deformity and functional impairment.  It should be differentiated from positional clubfoot, a common newborn condition that appears similar to congenital clubfoot but in which the foot can be passively manipulated into a neutral position.

Pathogenesis

Congenital clubfoot is an idiopathic condition characterized by abnormally shaped and positioned tarsal bones (eg, talus, calcaneus).  In a developing fetus with congenital clubfoot, the tissues surrounding the tarsal bones are underdeveloped, and the muscles are shortened and contracted.  The talus is displaced medially, and the calcaneus is in a varus position under the talus ( Figure 1).  This leads to a plantar-flexed foot with an adducted and internally rotated forefoot, resembling the shape of a golf club.

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Figures

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