Foot is turned under and towards the other foot (equinus and varus)

Short Achilles tendon

High and small heel

No creases behind Heel

Abnormal crease in middle of the foot

Foot is smaller in unilateral affection

Callosities at abnormal pressure areas

Internal torsion of the leg

Calf muscles wasting

Treatment

Treatment for clubfoot usually starts at birth. The goal of treatment for clubfoot is to obtain a plantigrade foot that is functional, painless, and stable over time, as well as cosmetically pleasing appearance. Correction of the deformity is to strengthen the weak muscles and weakened the strong muscles.

There are three types of treatment to correct the deformity, those are:

Manipulation

Exercise

Surgery

To maintain the correction, following method can be use

Plaster Cast

Orthosis / Splint

Bandaging

Orthosis

Orthosis is used to maintain the correction, the foot is first to be manipulated into maximal correction can be tolerated, and then the corrective position of the manipulation is maintained by the splint. Orthosis also can be prescribed post surgery, to maintain the correction done by surgery.

Orthotic options:

a. Dennis Brown splint

The splint is set at 60 to 70deg of external rotation, and 50 Dorsiflexion

b. Ankle Foot Orthosis

It can be used if the deformity is already reduced, and the child needs to walk.

c. Knee Ankle foot Orthosis set in 90deg knee Flexion

Maintain the foot abducted and externally rotated. 90deg knee flexion position to reduce the tension of gastrocnemius, which make easy to correct the equinus.

Complications

Fix deformity of Talipes Equino Varus

Patient walk with lateral border of foot touching the ground

Orthotic Treatment post complication

Fixed deformity cannot be corrected when it is neglected, the orthotic objectives are to accommodate the deformity and enhance mobility. Ankle Foot Orthosis which provide accommodation to the deformed foot can be prescribe to the patient