Talipes calcaneovalgus refers to a common paediatric foot deformity which stems from the intrauterine positioning of the child’s foot. The foot appears excessively dorsiflexed with the calcaneum in valgus and the dorsum of the foot making contact with the anterior aspect of the tibia.
As opposed to congenital vertical talus (CVT), a calcaneovalgus deformity does not involve shortening of the Achilles tendon or an equinus calcaneus. It is normally associated with external rotation of the calcaneus, an overstretched Achilles tendon and tightness in the anterior leg musculature.
Gore et al. describe the appearance of the calcaneovalgus foot as “up and out” with plantarflexion limited to a more neutral position as a result of the tight anterior soft tissue structures.
As stated by the authors, early treatment is often necessitated because of subsequent difficulties in the form of permanent muscle imbalance, peroneal tendon dislocation and delayed ambulation.
Depending on the extent of the severity, conservative treatment such as corrective stretching exercises implemented during early infancy can help in the resolution of mild-to-moderate cases of talipes calcaneovalgus deformity.
Mark A. Caselli, from the New York College of Podiatric Medicine, recommends serial immobilisation casting in the event that the foot fails to achieve full correction within three to four weeks of proper manipulation.
The author also recommends open toe straight last shoes and foot orthoses for maintaining optimal foot alignment following a stretching or casting regimen; it is essential to prevent recurrences by maintaining the corrected position after initial treatment of the deformity.
As the child matures, MASS4D® foot orthotics can be incorporated as part of a comprehensive active rehabilitation programme to provide further support to the foot in its optimally functional position while preventing the onset of other structural deformities.
This will promote normal ambulation to help the individual perform daily activities with much ease and agility and enhance postural stability to bring overall balance to the musculoskeletal system.
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Repetitive plantarflexion can lead to pain and mechanical limitation in the posterior ankle joint which is known as posterior ankle impingement syndrome. This pathology commonly occurs in ballet dancers and football players.