Methods of Treatment of Congenital Deformities of the Musculoskeletal System: Talipes Equinovarus

Abstract

Talipes equinovarus, also called clubfoot, is characterized by plantar flexion, inward tilting of the heel (from the midline of the leg), and adduction of the forefoot (medial deviation away from the leg’s vertical axis). Idiopathic congenital talipes equinovarus is the most common pediatric deformity and occurs in 1 in every 1000 live births. Even though it has been widely researched, the etiology of the condition remains poorly understood and is often described as being based on different factors. Genetic and environmental factors seem to have a major role in the development of this disease. If left untreated, it can result in long-term disability, deformity and pain. Interventions can be conservative (such as splinting or stretching) or surgical. Prenatal screening is key as treatment usually begins days after birth. Typical management of talipes equinovarus is non-operative and utilizes serial manipulation and casting, followed by bracing with Ponseti method. For cases unresponsive to the conservative methods, a variety of surgical approaches is used to address the deformity and sustain a full correction of the musculoskeletal system. A key point for full recovery is the utilization of intensive physiotherapy in the posttreatment period. We follow the case of a male patient, who was diagnosed with talipes equinovarus prenatally and observe his non – surgical and surgical treatment over the course of 28 months, which resulted in full recovery.