Despite common occurrence, congenital talipes equinovarus (clubfoot) is still a subject of controversy. It poses a significant problem with its unpredictable outcome, especially when the presentation for treatment is late. The true etiology remains unknown although many theories have been put forward. A standard management scheme is difficult as there is no uniformity in the pathoanatomy, class...

Club foot – or, more correctly, congenital talipes equinovarus (CTEV) 1 – describes a specific foot deformity of midfoot cavus, forefoot adduction, hindfoot varus and equinus. The World Health Organisation has estimated that 100’000 children are born with CTEV, with 80% occurring in the developing world. 2 Ignacio Ponseti died on October 18 2009 aged 95. He was a pioneer in paediatric ort...

Congenital talipes equinovarus (clubfoot) is a relatively common congenital deformity, affecting about 1 to 3 per thousand live births, generally idiopathic but sometimes associating different conditions: chromosomal anomalies, neuromuscular or urological diseases. Nowadays, the diagnosis is made prenatally, by having a detailed fetal ultrasound scan. The standard care of this condition is a no...

Between 1988 and 1995, we studied 91 club feet from a series of 120 recalcitrant feet in 86 patients requiring surgical treatment. There were 48 boys and 20 girls. The mean age at operation was 8.9 months. Surgery consisted of an initial plantar medial release followed two weeks later by a posterolateral release. This strategy was adopted specifically to address the problems of wound healing as...

The content covers congenital, developmental and degenerative conditions, trauma, growth and infection related disorders, and clinically relevant basic scientific research. Congenital abnormalities affecting the limbs remains a great challenge to orthopaedic surgeons, but development in this field is swinging from amputation and prosthetic fitting to bone and soft tissue reconstruction due to b...

We assessed whether there is a recognisable pattern of facial morphology in photographs of a series of 62 children with idiopathic congenital talipes equinovarus (CTEV). Photographs were scored for a number of facial characteristics by a research team comprising orthopaedic surgeons and clinical geneticists, to identify a subgroup of children with idiopathic CTEV, who shared characteristic faci...

Achilles tenotomy is a recognised step in the Ponseti technique for the correction of idiopathic congenital talipes equinovarus in most percutaneous cases. Its use has been limited in part by concern that the subsequent natural history of the tendon is unknown. In a study of 11 tendons in eight infants, eight tendons were shown to be clinically intact and ten had ultrasonographic evidence of co...

A female child born preterm with intrauterine growth retardation and presenting with facial dysmorphism with clefts, microcephaly, limb deformities, and congenital abnormalities involving cardiovascular and urinary systems is described. Chromosomal analysis showed a de novo 46,XX,r(4)(p15.3q35) karyotype. The clinical features of the patient were compared with the phenotypic characteristics of ...