Clubfoot is a pathological deformity that causes the leg and its appended foot to resemble a clubbing instrument. Two varieties of clubfoot have been identified. The more severe talipes equinovarus is a condition in which the heel and forefoot are inverted, the forefoot is adducted, and the entire foot is plantar flexed. Figure 183-3 shows bilateral clubfoot in a newborn; Figure 183-4 shows an untreated right clubfoot. Talipes calcaneovalgus is characterized by eversion of the heel and forefoot, abduction of the forefoot, and dorsiflexion of the entire foot (Figure 183-5). Both forms occur in approximately 1 of every 200 live births, are bilateral in 50% of the cases, and affect boys almost twice as frequently as girls.

In the newborn period, functional deformities of the feet secondary to in utero positioning will often mimic both varieties of clubfoot. These functional deformities can be differentiated readily from clubfoot based on flexibility of the foot. The functionally deformed foot can be brought easily to a neutral position and even overcorrected, which is not possible when pathological deformities are present.