Congenital Talipes Equinovarus
Congenital abnormality of the foot characterised by
- hindfoot equinus & varus
- forefoot Adduction
- midfoot Supination
Latin: talus - ankle / pes - foot / equinus - horse like
Foot
- pipe stem calf
- short wide foot
- small heel
- curved lateral border
Rockerbottom foot / Persian Slipper Foot
Uncommon
50% bilateral
Doesn't delay walking
- may present in toddler with callus under talus head
Congenital anomalies
- CNS disorders
- spina bifida & diastematomyelia ~10%
- arthrogryposis
- neurofibromatosis
Palmar Fibromatosis
AD with variable penetration
Murrell's Theory of Pathogenesis
1. Microvascular ischaemia
Hyperextension of MTPJ and PIPJ / DIPJ flexion
- usually all toes affected
1. Complex hammer
- hammer toe with MTPJ extension
- hammer usually affects second toe
2. Curly toe
Congenital fibrous, cartilaginous or bony connection of 2 or more tarsal bones
- due to failure of segmentation
Peroneal Spastic Flat Foot
- tarsal coalition
- tarsal pain
- reduced STJ motion
- rigid pes planus
- peroneal muscle spasm / tightness
Present in 6% of population
- symptomatic in 1% of population
Bilateral in 50%
Condition present at birth
- ankle dorsiflexed & in valgus
- foot abducted
1 in 1000 births
Probably result of intrauterine positioning
- packaging defect
Oligohydramnios
DDH