Summary
Definition
History and exam
Key diagnostic factors
- positive family history
- equinus deformity
- hind foot in varus and adducted
- forefoot adducted
Other diagnostic factors
- male sex
- hip dysplasia
- neurologic or chromosomal abnormalities
- smaller lower extremity
- dimpling, hairy patch along spine line
Risk factors
- family history of equinovarus foot deformity
- male sex
- associated congenital abnormalities
- parental smoking
Diagnostic tests
Tests to consider
- anteroposterior and lateral radiographs of foot
- dynamic hip ultrasound
- pelvic radiographs
- CT foot
- CT spine
- abdominal ultrasound
Treatment algorithm
at initial diagnosis
relapse
Contributors
Authors
Scott E. Van Valin, MD

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.
References
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.
Differentials
- Metatarsus adductus
- Skewfoot
- Calcaneovalgus or talipes calcaneal valgus
More DifferentialsGuidelines
- Diagnosis and treatment of idiopathic congenital clubfoot
- Management of clubfoot deformity in children up to walking age
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