ABSTRACT
Congenital talipes equinovarus (CTEV) is a hereditary condition of polygenic inheritance to which environmental factors are added in utero, resulting in arrested development. It occurs in 1 in 1000 live births and is commoner in males (2:1). There is a flexion deformity at the ankle which exposes the anterolateral dome of the talus, and medial and downward subluxation of the navicular which exposes the lateral neck of the talus. The medial and plantar fibro-elastic structures consequently shorten. There may be associated deformity of the talus (less often the calcaneum) with hypoplasia of the calf muscles. Clubfeet are classed as ‘easy’, when the deformity is less severe, is correctable in the same way as ‘postural clubfoot’ (see Congenital foot deformities, p. 88) and does not recur, or ‘resistant’ which needs protracted treatment and never returns to normal. Other associated congenital abnormalities are seen in 10-15% of patients with CTEV.
