talipes

a deformity in which the foot is twisted out of normal position; see also clubfoot and see illustration. It may have an abnormally high longitudinal arch (talipes cavus) or it may be in dorsiflexion (talipes calcaneus), in plantar flexion (talipes equinus), abducted and everted (talipes valgus or flatfoot), adducted and inverted (talipes varus), or various combinations of these (talipes calcaneovalgus, talipes calcaneovarus, talipes equinovalgus, or talipes equinovarus).



There are several theories as to the cause of clubfoot. A familial tendency or arrested growth during fetal life may contribute to its development, or it may be caused by a defect in the ovum. It sometimes accompanies meningomyelocele as a result of paralysis. In mild clubfoot there are slight changes in the structure of the foot; more severe cases involve orthopedic deformities of both the foot and leg. Although clubfoot is usually congenital, an occasional case in an older child may be caused by injury or poliomyelitis.

Treatment varies according to the severity of the deformity. Milder cases may be corrected with casts that are changed periodically, the foot being manipulated into position each time the cast is changed so that it gradually assumes normal position. A specially designed splint may also be used, made of two plates attached to shoes with a crossbar between the plates and special set screws so that the angulation of the foot can be changed as necessary. More severe deformities require surgery of the tendons and bones, followed by the application of a cast to maintain proper position of the joint.