[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Embryology](https://durgical.com/en/embryology/) › [Skeleton, muscles, limbs and skin](https://durgical.com/en/embryology/#a-musculoskeletal) › Clubfoot (talipes equinovarus) [Embryology](https://durgical.com/en/embryology/) · [Skeleton, muscles, limbs and skin](https://durgical.com/en/embryology/#a-musculoskeletal) # Clubfoot (talipes equinovarus) - Malformation The foot is born turned inwards and downwards; with serial casts from the first weeks it can almost always be corrected. Updated 2026-11-01 **See it in 3D:** [Talus](https://durgical.com/en/anatomy/talus/) · [Calcaneus](https://durgical.com/en/anatomy/calcaneus/) · [Navicular](https://durgical.com/en/anatomy/navicular-bone/) · [Cuboid](https://durgical.com/en/anatomy/cuboid-bone/) · [Achilles tendon](https://durgical.com/en/anatomy/calcaneal-tendon/) · [Tibialis posterior](https://durgical.com/en/anatomy/tibialis-posterior-muscle/) · [Tibia](https://durgical.com/en/anatomy/tibia/) ## Key points - Cavus, adductus, varus and equinus. - About 1 in 1000; two boys for every girl; 50 % bilateral. - Rigid (true) foot versus positional foot (corrects by hand). - Look for myelomeningocele and arthrogryposis. - Early treatment with serial casts. ## What it is Congenital clubfoot is a rigid deformity of the foot and lower leg: the foot points down and in. It affects about 1 in 1000 newborns, more often boys, and is bilateral in about half. It is almost always idiopathic, but neurological causes and syndromes must be ruled out. ## Embryological cause - The fetal foot normally passes through an equinus and supinated position early in the fetal period and then rotates to its final position; in clubfoot that correction stalls. - The talar neck is deviated medially and plantarward; the navicular is displaced medially. - Posterior and medial soft tissues (Achilles tendon, tibialis posterior) are short and fibrotic. - Genetic component: about 1 in 4 cases is familial; variants in PITX1, a hind-limb gene, have been described. - Secondary forms: neuromuscular weakness (myelomeningocele, arthrogryposis) or intrauterine compression. ## Markers - PITX1 - TBX4 - CAVE ## How it presents - Four components: cavus, forefoot adductus, hindfoot varus and equinus. - A rigid foot that cannot be brought to neutral by hand, unlike a positional foot. - A thin calf and a slightly shorter foot on the affected side. - Associations: spina bifida, arthrogryposis, trisomy 18 and hip dysplasia. - With serial casting (Ponseti method), Achilles tenotomy and bracing, most children gain a functional foot. ## Diagnosis - Second-trimester prenatal ultrasound: the foot is seen in the same plane as the tibia and fibula. - At birth the diagnosis is clinical. - Examine the spine and the hips to look for causes or associations. ## Memory aid The foot 'stopped halfway through its turn': it was pointing in and down like every fetal foot and never finished rotating. ## Test yourself Think of the answer, then tap the question to see it. ## What are the four components of clubfoot? Cavus, forefoot adduction, hindfoot varus and equinus. ## How is a true clubfoot told apart from a positional one? A positional foot is easily brought to a normal position by hand; a true clubfoot is rigid. ## Which neurological malformation is looked for in a newborn with clubfoot? Myelomeningocele, because distal muscle weakness can cause the deformity. ## When can clubfoot be seen before birth? On the second-trimester ultrasound, when the foot appears in the same plane as the leg bones. [Add to my cards (4)](https://durgical.app/estudiar/?add=/en/embryology/clubfoot/) ## See it in 3D The structures of Durgical's 3D anatomy where it is found. - [Talus](https://durgical.com/en/anatomy/talus/) - [Calcaneus](https://durgical.com/en/anatomy/calcaneus/) - [Navicular](https://durgical.com/en/anatomy/navicular-bone/) - [Cuboid](https://durgical.com/en/anatomy/cuboid-bone/) - [Achilles tendon](https://durgical.com/en/anatomy/calcaneal-tendon/) - [Tibialis posterior](https://durgical.com/en/anatomy/tibialis-posterior-muscle/) - [Tibia](https://durgical.com/en/anatomy/tibia/) ## Related - [Limb development: the apical ectodermal ridge, ZPA and limb rotation](https://durgical.com/en/embryology/limb-development-the-apical-ectodermal-ridge-zpa-and-limb-rotation/) - [Developmental dysplasia of the hip](https://durgical.com/en/embryology/developmental-dysplasia-of-the-hip/) - [Neural tube defects: anencephaly, spina bifida and encephalocele](https://durgical.com/en/embryology/neural-tube-defects-anencephaly-spina-bifida-and-encephalocele/) - [Amniotic fluid: polyhydramnios and oligohydramnios](https://durgical.com/en/embryology/amniotic-fluid-polyhydramnios-and-oligohydramnios/) - [Prenatal diagnosis: ultrasound, serum screening, cell-free DNA, CVS, amniocentesis](https://durgical.com/en/embryology/prenatal-diagnosis-ultrasound-serum-screening-cell-free-dna-cvs-amniocentesis/) ## Related conditions - [Clubfoot (talipes equinovarus)](https://durgical.com/en/conditions/clubfoot/) - [Spina bifida (myelomeningocele)](https://durgical.com/en/conditions/spina-bifida/) - [Developmental dysplasia of the hip](https://durgical.com/en/conditions/developmental-dysplasia-of-the-hip/) [← All of embryology](https://durgical.com/en/embryology/) Educational content on embryonic development; not a guide to prenatal diagnosis or to medicines in pregnancy and no substitute for a health professional's advice. No doses are given. Sources: [Clubfoot: MedlinePlus Medical Encyclopedia](https://medlineplus.gov/ency/article/001228.htm) (MedlinePlus, US National Library of Medicine, 2026); Langman's Medical Embryology, 13th ed., ch. 12: Limbs (Wolters Kluwer, 2015). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/embryology/clubfoot/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/embryology/clubfoot/