Calcaneovalgus

Definition

 

Condition present at birth

- ankle dorsiflexed & in valgus

- foot abducted

 

Epidemiology

 

1 in 1000 births

 

Aetiology

 

Probably result of intrauterine positioning

- packaging defect

 

Associations

 

Oligohydramnios

DDH

 

Increased incidence of flexible pes planus in later life

 

Clinical

 

Foot can usually be completely corrected passively

 

DDx

 

Congenital Posteromedial Bow of Tibia

- foot dorsiflexed

- tibial bow can be palpated

- confirmed with Xray

- not harmful

- can be associate with LLD / 2 cm

- strong association with calcaneovalgus

 

Congenital Vertical Talus

- calcaneus in equinus

- rockerbottom deformity

- deformity can't be corrected

- confirmed on xray

 

Neurological Dysfunction

- spinal dysraphism L5

- absence of triceps surae function

- may be cutaneous manifestation on back

- confirmed with spine xray

 

Management

 

Usually resolves spontaneously in first year

 

If severe, treated with regular manipulation

 

Occasionally need plantarflexion-inversion splintage