Clubfoot

Clubfoot or congenital talipes equinovarus is a common congenital abnormality of uncertain aetiology. It presents with fixed cavus, adductus, varus and equinus of the foot. Serial manipulation and casting using the Ponseti technique can produce a plantigrade, pain-free, functional foot in the majority of cases in the long term. Most patients treated this way will require only minimal surgery, such as Achilles tenotomy, dramatically reducing the need for extensive, open releases. Recurrent and complex clubfoot can also be treated by the Ponseti technique but some challenging cases still require surgical correction. Those that resist primary or revision operations can be salvaged by arthrodesis but the long term results are less predictable. This review will summarise the current theories on aetiology and pathogenesis, assessment and management according to the Ponseti regime, surgical options for primary clubfoot and recurrences and possible future directions.