talipes

Talipes is a general term for deformities of the foot and ankle in relation to the leg. It encompasses several forms, most notably congenital talipes equinovarus (CTEV), commonly known as clubfoot, in which the foot is twisted inward and downward. Other congenital talipes include calcaneovalgus (heel in an abnormal angle with the foot dorsiflexed and everted), cavus (high-arched foot with forefoot or hindfoot deformities), and planovalgus or valgus instabilities of the hindfoot.

Causes of talipes are often multifactorial. Many cases are idiopathic, but genetic factors, neuromuscular conditions, and associated congenital anomalies can contribute. Talipes may be detected at birth or, in some instances, identified during pregnancy via ultrasound. A thorough evaluation is typically performed to assess for concomitant syndromes or other musculoskeletal problems.

Diagnosis relies on physical examination and, when appropriate, imaging studies to define the precise bones and joints involved and to plan treatment. Prenatal detection can improve preparedness and management planning.

Management depends on the specific type and severity. Congenital talipes equinovarus is most commonly treated with the Ponseti method—gentle manipulation and serial casting, often followed by a percutaneous Achilles tenotomy and subsequent bracing to prevent relapse. Other deformities may respond to orthotics, physical therapy, or, in some cases, surgical intervention to correct bone and soft-tissue abnormalities.

Prognosis is favorable with early diagnosis and appropriate treatment, though relapse can occur, particularly if bracing protocols are not followed. Talipes occurs in about 1 in 1,000 live births, is more common in males, and can be bilateral in a substantial minority of cases.