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Clubfoot is a topic covered in the 5-Minute Pediatric Consult.

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  • Clubfoot (talipes equinovarus) is a complex foot deformity consisting of four components:
    • Equinus (plantar flexion)
    • Hindfoot varus (toward the midline)
    • Forefoot adductus
    • Midfoot cavus (high arch with overextension)
  • Untreated clubfoot can prevent the development of normal gait and result in secondary bone changes leading to lifetime disability.


  • Familial occurrence in 25%
  • Male > female (2.5:1)
  • 50% of cases are bilateral.
  • Clubfoot is the most common congenital deformity of the lower extremity.
  • 1 to 2:1,000 births in United States
  • Lowest prevalence in Chinese, 0.39:1,000
  • Highest prevalence in Polynesians, 7:1,000


  • Both intrinsic and extrinsic causes have been associated with the development of clubfoot.
  • Intrinsic causes:
    • Neurogenic (spina bifida)
    • Muscular (anomalous or atrophic musculature)
    • Vascular (hypoplastic anterior tibial artery)
    • Connective tissue diseases (arthrogryposis, Loeys-Dietz syndrome)
    • Abnormal primary bone formation
    • Interruption of the transcriptional pathway PITX1-TBX4 which is critical to early limb development has been linked to development of clubfoot and similar deformities.
  • Extrinsic causes:
    • Intrauterine immobility (multiple gestations, malpresentation, uterine abnormalities, oligohydramnios)
    • Maternal cigarette smoke exposure


  • Most cases (80%) are idiopathic (multifactorial with genetic and environmental influences).
  • Remaining cases likely associated with associated structural, genetic, and/or chromosomal anomalies
  • Rapid recurrence of deformity should prompt a thorough examination for possible underlying neuromuscular etiologies.

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Cabana, Michael D., editor. "Clubfoot." 5-Minute Pediatric Consult, 8th ed., Wolters Kluwer, 2019. Pediatrics Central, peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617349/all/Clubfoot.
Clubfoot. In: Cabana MD, ed. 5-Minute Pediatric Consult. 8th ed. Wolters Kluwer; 2019. https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617349/all/Clubfoot. Accessed April 22, 2019.
Clubfoot. (2019). In Cabana, M. D. (Ed.), 5-Minute Pediatric Consult. Available from https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617349/all/Clubfoot
Clubfoot [Internet]. In: Cabana MD, editors. 5-Minute Pediatric Consult. Wolters Kluwer; 2019. [cited 2019 April 22]. Available from: https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617349/all/Clubfoot.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Clubfoot ID - 617349 ED - Cabana,Michael D, BT - 5-Minute Pediatric Consult UR - https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617349/all/Clubfoot PB - Wolters Kluwer ET - 8 DB - Pediatrics Central DP - Unbound Medicine ER -