Peds

Talipes Calcaneovalgus

search

Talipes Calcaneovalgus, Calcaneovalgus Deformity

  • Epidemiology
  1. Most common neonatal foot deformity
  2. More common in females
  • Etiology
  1. Results of positional confinement in utero
  • Signs
  1. Images
    1. OrthoPedsFootCV.jpg
  2. Easy to diagnose shortly after birth
    1. Foot has up and out appearance
  3. Foot dorsiflexes easily (long heel cord, ligaments lax)
    1. Dorsiflex foot so toes touch anterior tibia
    2. Foot often held in extreme dorsiflexion
    3. Limited plantar flexion (less than 90 degrees)
  4. Lateral Sole deviation (banana shaped)
    1. Feet are everted (facing away from each other)
  5. Lateral Heel deviation
    1. View from behind with foot in dorsiflexion
    2. Heel position is valgus (medial malleoli are closer)
  • Differential Diagnosis
  • Severe, refractory calcaneovalgus
  1. Congenital Vertical Talus (Convex Pes Valgus)
  • Management
  1. Stretch child's foot
    1. Start as early as possible
    2. Gentle plantar flexion of foot with mild inversion
      1. Stretch dorsal tendons and ligaments
    3. Repeat frequently (e.g. at each diaper change)
  2. Firm, high-top lace up shoes or Splinting
    1. Indicated for cases refractory to Stretching
  3. Serial Corrective cast indications
    1. Foot remains severely deformed (rare)
  • Prognosis
  1. Excellent overall prognosis
  2. Improves spontaneously and rapidly
  3. Partial correction results in a Flexible Flatfoot
  • Patient Resources
  1. Hughston Sports Medicine Foundation
    1. http://www.hughston.com/hha/a_13_4_1.htm
  • References
  1. Hoppenfeld (1976) Exam. Spine Extremities, p.159-60,223
  2. Churgay (1993) Am Fam Physician 47(4):883 [PubMed]
  3. Gore (2004) Am Fam Physician 69(4):865-72 [PubMed]
  4. Hoffinger (1996) Pediatr Clin North Am 43:1091-111 [PubMed]