Although many theories have been offered about the etiology of clubfoot, none has been proved. Most cases are idiopathic and occur in an otherwise-normal infant. If a family has a child with clubfoot, then the incidence in subsequent siblings is 3% to 4%. If 1 parent and a child have clubfoot, then subsequent children have a 25% chance of having clubfoot.

Clubfoot is characterized by 4 distinct components: (1) plantar flexion (equinus) of the ankle, (2) adduction (varus) of the heel (hindfoot), (3) high arch (cavus) at the midfoot, and (4) adduction of the forefoot.

When clubfoot is present, associated neurologic, muscular, or other skeletal anomalies should be sought. Neuromuscular clubfoot is a deformity associated with disorders such as arthrogryposis, meningomyelocele, and congenital constriction band syndrome.

Radiographic examination is required at the time of diagnosis and periodically during treatment to delineate the pathological finding and to guide management.