Q66.4 Congenital talipes calcaneovalgus

Name of the Condition

• Congenital Talipes Calcaneovalgus

Summary

Congenital talipes calcaneovalgus is a foot deformity present at birth where the foot is positioned upward and outward, with the heel elevated and the forefoot dorsiflexed. This condition affects the flexibility of the ankle joint and is typically identified shortly after birth.

Causes

The deformity often results from intrauterine positioning, such as pressure from the uterine wall or limited space during pregnancy. It is not strongly associated with genetic factors and is generally considered a developmental positioning issue.

Risk Factors

• Firstborn status, due to reduced uterine space.
• Intrauterine crowding, such as with twins or large fetuses.
• Abnormal fetal positioning, including breech presentation.

Symptoms

• The foot appears dorsiflexed (toes pulled upward) and everted (turned outward).
• Limited ankle movement.
• The condition is typically painless in newborns.

Diagnosis

Physical examination after birth is usually sufficient for diagnosis. Imaging, such as X-rays, may be used to rule out underlying bone abnormalities in rare cases.

Treatment Options

• Stretching exercises and physical therapy to improve flexibility.
• Most cases resolve spontaneously as the child grows.
• Orthotic devices or casting may be used for persistent cases.

Prognosis and Follow-Up

Prognosis is generally favorable, with most cases resolving without long-term issues. Follow-up may involve monitoring foot alignment and mobility during routine pediatric visits.

Complications

• Persistent deformity if left untreated.
• Difficulty with shoe fitting as the child grows.
• Rarely, associated musculoskeletal issues.

Lifestyle & Prevention

• Gentle stretching exercises as recommended by a healthcare provider.
• Avoiding restrictive footwear in infancy.
• Regular monitoring during growth and development.

When to Seek Professional Help

Seek medical attention if the deformity worsens, causes pain, or interferes with walking. Early evaluation is recommended for persistent or severe cases.

Tips for Medical Coders

Document the affected foot (unspecified, right, or left) as applicable. Ensure clinical notes support the diagnosis and specify any treatment or follow-up care provided.