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Equinovarus foot deformity

  • Overview
  • Theory
  • Diagnosis
  • Management
  • Follow up
  • Resources
Last reviewed: 10 Aug 2025
Last updated: 31 Aug 2023

Summary

Definition

History and exam

Key diagnostic factors

  • positive family history
  • equinus deformity
  • hind foot in varus and adducted
  • forefoot adducted
Full details

Other diagnostic factors

  • male sex
  • hip dysplasia
  • neurologic or chromosomal abnormalities
  • smaller lower extremity
  • dimpling, hairy patch along spine line
Full details

Risk factors

  • family history of equinovarus foot deformity
  • male sex
  • associated congenital abnormalities
  • parental smoking
Full details

Diagnostic tests

Tests to consider

  • anteroposterior and lateral radiographs of foot
  • dynamic hip ultrasound
  • pelvic radiographs
  • CT foot
  • CT spine
  • abdominal ultrasound
Full details

Treatment algorithm

ACUTE

at initial diagnosis

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Contributors

Authors

Scott E. Van Valin, MD
Scott E. Van Valin

Associate Professor

Pediatric Orthopaedic Surgery

Medical College of Wisconsin

Milwaukee

WI

Disclosures

SEVV declares that he has no competing interests.

Peer reviewers

Shyam Kishan, MD

Assistant Professor of Orthopaedics

Department of Orthopaedic Surgery

Loma Linda University

Loma Linda

CA

Disclosures

SK declares that he has no competing interests.

Mark J. Adamczyk, MD

Pediatric Orthopedic Surgeon

Akron Children's Hospital

Akron

OH

Disclosures

MJA declares that he has no competing interests.

Nigel Kiely, FRCS

Consultant Orthopaedic Surgeon

Robert Jones and Agnes Hunt Orthopaedic and District Hospital NHS Trust

Oswestry

Shropshire

UK

Disclosures

NK declares that he has no competing interests.

Donald Campbell, MD

Consultant

Paediatric Orthopaedic Surgery

Ninewells Hospital and Medical School

Dundee

Scotland

UK

Disclosures

Not disclosed.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

Cady R, Hennessey TA, Schwend RM. Diagnosis and treatment of idiopathic congenital clubfoot. Pediatrics. 2022 Feb;149(2):e2021055555.Full text  Abstract

British Society for Children’s Orthopaedic Surgery (BSCOS). Management of clubfoot deformity in children up to walking age. Jul 2021 [internet publication].Full text

Besselaar AT, Sakkers RJB, Schuppers HA, et al. Guideline on the diagnosis and treatment of primary idiopathic clubfoot. Acta Orthop. 2017 Mar 7;88(3):305-9.Full text  Abstract

Staheli L, ed. Clubfoot: Ponseti management, 3rd ed. Seattle, WA: Global HELP; 2009.Full text

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
  • Equinovarus foot deformity images

  • Differentials

    • Metatarsus adductus
    • Skewfoot
    • Calcaneovalgus or talipes calcaneal valgus
    More Differentials

  • Guidelines

    • Diagnosis and treatment of idiopathic congenital clubfoot
    • Management of clubfoot deformity in children up to walking age
    More Guidelines
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