Here is a detailed description about CTEV (Clubfoot):

CTEV – Congenital Talipes Equinovarus

CTEV, commonly known as Clubfoot, is a congenital deformity of the foot and ankle in which one or both feet are twisted inward and downward. It is present at birth and is one of the most common pediatric orthopedic conditions.

Meaning of CTEV

  • C – Congenital → Present at birth
  • T – Talipes → Related to ankle and foot
  • E – Equinus → Foot pointing downward (like standing on toes)
  • V – Varus → Heel turned inward (foot curved inward)

So, the foot appears inward-turned and toe-downward — giving a club-shaped appearance.

Types of Clubfoot (CTEV)

1. Idiopathic (Most common)

  • Occurs without any other medical condition
  • Usually seen in otherwise healthy babies

2. Syndromic

  • Associated with neuromuscular disorders (e.g., spina bifida, arthrogryposis)

3. Postural

  • Due to abnormal positioning in the womb, usually flexible and easily correctable

Causes / Risk Factors

The exact cause is unknown, but possible factors include:

  • Genetic influence (family history)
  • Intrauterine position
  • Neurological or muscular imbalance
  • Connective tissue or bone development issues
  • Associated syndromes

More common in:

  • Males (2:1 ratio)
  • First-born babies
  • When there is less amniotic fluid

Clinical Features

  • Foot is twisted inward and downward
  • Calf muscle appears smaller
  • Foot size may be shorter
  • Limited ability to move foot upward or outward
  • Often affects both feet (bilateral) in 50% of cases
  • Painless at birth

Diagnosis

  • Clinical examination immediately after birth
  • Prenatal diagnosis possible via ultrasound after 20 weeks gestation
  • X-ray rarely needed in newborns

Treatment

Ponseti Method (Gold Standard Treatment)

Most popular and effective, with 95% success rate.
Steps:

  1. Serial Manipulation & Casting (weekly cast changes for 5–6 weeks)
  2. Tenotomy (Achilles tendon release) if needed to correct equinus deformity
  3. Foot Abduction Brace (FAB) to prevent recurrence
    • 23 hours/day for 3 months
    • Night-time only until age 4–5 years

Other options

  • French functional physiotherapy method
  • Surgical release (for resistant or relapsed cases)

Goals of treatment

  • Straight, pain-free, fully functional and plantigrade foot
  • Ability to walk, run and play normally
  • Prevent long-term disability and deformity

Complications if untreated

  • Difficulty walking
  • Permanent deformity
  • Callus formation
  • Leg length difference
  • Social and psychological impact

Summary Table

Feature Description
Full Form Congenital Talipes Equinovarus
Type Congenital foot deformity
Appearance Foot turned inward & downward
Treatment Ponseti method with braces
Outcome Excellent with early management

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