Talipes (Clubfoot)

Talipes, commonly known as clubfoot, is a birth defect in which one or both feet are twisted out of their normal shape or position. It is one of the most common musculoskeletal birth defects and is highly treatable, especially when treatment begins early.

• One or both feet turned inward and downward at birth
• The affected foot may appear shorter, with a deeper crease on the sole
• The calf muscle on the affected side may appear smaller
• Without treatment, the deformity does not resolve on its own and worsens as the child grows and begins to walk, causing difficulty with mobility

• In most cases, no specific underlying cause is identified (idiopathic clubfoot).
• Can occasionally occur alongside other underlying conditions affecting the muscles or nervous system, or as part of certain genetic syndromes.
• Family history of clubfoot slightly increases risk.

• Usually visible and diagnosed at birth through examination of the foot's shape and position.
• Occasionally detected on antenatal ultrasound before birth.
• Assessment for other associated conditions may be considered, particularly if the clubfoot is severe or occurs alongside other abnormalities.

The Ponseti method — a series of gentle manipulations and plaster casting of the foot, usually starting in the first few weeks of life — is the standard, highly effective first-line treatment and can correct most cases without major surgery.

A minor procedure to release a tight tendon at the back of the ankle is often needed partway through the casting process.

After correction, the child wears a brace, initially for most of the day and night and gradually reduced, for several years to prevent the deformity from returning — consistent brace use is critical to long-term success.

More severe or previously untreated cases may require more extensive surgery, ideally avoided where early Ponseti treatment is accessible, as outcomes are generally best with early, non-surgical correction.

• Seek assessment and treatment as early as possible after birth, ideally within the first couple of weeks, since early treatment gives the best outcomes and avoids the need for major surgery.
• Ensure consistent use of the corrective brace for as long as recommended, even once the foot appears normally shaped, since stopping too early is a common cause of the deformity returning.
• Attend all follow-up appointments during the casting and bracing process.
• Seek support and information from a specialist clubfoot treatment programme where available, given the specific expertise required.