Equinovarus foot deformity

Equinovarus foot deformity is one of the most common birth defects (1 in 1000 live births).

Can be identified on prenatal ultrasound (true-positive rate 83%).

Exam demonstrates a hindfoot in varus, a forefoot that is adducted, and an ankle in equinus.

Prognosis is good with a nonoperative approach using the Ponseti method of treatment (bracing and serial casting).

Achilles tenotomy is used in >90% of cases to improve dorsiflexion.

Tibialis anterior tendon transfer and posteromedial release and tendon lengthening are further surgical treatment options.

Equinovarus foot deformity, better known as clubfoot, is a relatively common birth defect. It can occur on average in 1 in 1000 live births.[1]Barker S, Chesney D, Miedzybrodzka Z, et al. Genetics and epidemiology of idiopathic congenital talipes equinovarus. J Pediatr Orthop. 2003;23:265-272. http://www.ncbi.nlm.nih.gov/pubmed/12604963?tool=bestpractice.com [2]Dietz F. The genetics of idiopathic clubfoot. Clin Orthop Relat Res. 2002;(401):39-48. http://www.ncbi.nlm.nih.gov/pubmed/12151881?tool=bestpractice.com [3]Besselaar AT, Kamp MC, Reijman M, et al. Incidence of congenital idiopathic clubfoot in the Netherlands. J Pediatr Orthop B. 2018 Nov;27(6):563-567. https://www.doi.org/10.1097/BPB.0000000000000525 http://www.ncbi.nlm.nih.gov/pubmed/29965828?tool=bestpractice.com [4]Ansar A, Rahman AE, Romero L, et al. Systematic review and meta-analysis of global birth prevalence of clubfoot: a study protocol. BMJ Open. 2018 Mar 6;8(3):e019246. https://bmjopen.bmj.com/content/8/3/e019246.long http://www.ncbi.nlm.nih.gov/pubmed/29511012?tool=bestpractice.com ​​ The foot has a classic appearance of maximum equinus, as well as varus, adduction, and cavus deformities.