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Talipes is a congenital deformity that develops in the womb during the first trimester (between 8 to 12 weeks) and causes an abnormal twisting of the ankles, heels, toes and feet. Talipes is present in one of every 1,000 childbirths in the United States (US), and 95 percent of these incidences are known as congenital talipes equinovarus (CTEV) or clubfoot. This type causes the foot to be curled inwards with toes pointing downward.
Causes. Among the causes of talipes is the abnormal position of the feet and limited space in the womb during fetal development, which can result in malformed tendons, muscles and bones. Furthermore, the lack of amniotic fluid in the sac surrounding the fetus, or oligohydramnios, can increase pressure on the feet, leading to talipes as well.
While there is no conclusive proof that talipes is hereditary, statistics indicate that there is a three to four percent probability that a child will develop it if one parent has this deformity. This percentage increases to 15 percent if both parents are affected. For normal parents who have a child with this problem, there is a two to five percent chance that their next child will have talipes. Additionally, male babies are twice as likely to be afflicted with this condition than female babies.
Treatment. Treatment for talipes should commence immediately after birth. The goal is to restore the feet to their normal position to enable proper function as well as eliminate pain and deformity. The treatments available are:
After this, a special splint called the Denis-Browne splint is put in place. This splint is made of two high-top, open-toed shoes connected by a bar, which is adjusted according to the correct position of the feet. The splint is worn full-time for two to three months and then only at night for the next two to four years.
The risk of recurrence of talipes is up to 25 percent until the child reaches one year old. Even so, constant follow-up and careful observation are required throughout childhood and adolescence. Without any recurrence, children with talipes will continue to lead normal and active lives.
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