Congenital Talipes Equinovarus (CTEV)

What is Congenital Talipes Equinovarus CTEV or Clubfoot? 

Congenital Talipes Equinovarus (CTEV) or Clubfoot is a congenital birth defect that affects the baby’s feet and ankles. The feet are turned inward and appear twisted. There’s a 0.1% chance of babies being born with twisted feet. Their odd-shaped feet point in the wrong direction. They can appear to be upside down. That’s why this condition is called clubfoot. Thankfully, babies born with this condition are healthy in other ways. Some have one curled foot, while others have this condition in both feet.

This condition manifests because of underlying problems with the tendons. Patients have shorter and tighter tissues in their legs and feet. So, the tendons are unable to connect the feet muscle to the bone properly. This causes the feet to twist. Thankfully, this condition is pain-free. But, if left untreated, affected children may have permanent limps. There are various safe, child-free nonsurgical treatments for clubfoot.

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Congenital Talipes Equinovarus or CTEV is a congenital birth defect that affects the baby’s feet and ankles. The feet are turned inward and appear twisted. There’s a 0.1% chance of babies being born with twisted feet.

Symptoms of Clubfoot or Congenital Talipes Equinovarus or CTEV

Here are the main symptoms of this condition:

  • The top regions of the feet are usually twisted downward/inward, which also makes the heel turn inward.
  • The affected feet appear slightly shorter as their calf muscles are underdeveloped.
  • Children with abnormally shaped feet can also have extra-tight Achilles tendons (heel cords).
  • Since this condition doesn't cause any discomfort or pain, parents need to be extra aware. They must document the changes in their children’s feet movements and relay this info to physiotherapists.

Causes of Congenital Talipes Equinovarus (CTEV) or Clubfoot

There’s no specific cause of this condition. Some children are born with abnormal bones, tendons, and ligaments in their feet (shapes, sizes, positions). These abnormalities disrupt the positioning of their feet. Some suggest maternal smoking during pregnancy is the root cause of this condition.

But, that claim isn’t verified by science. However, feet that are abnormally positioned inside uteruses during pregnancies are likelier to look odd in terms of their shapes. Scientists assume that CTEV is caused by the combination of genetics, prenatal care, and nurture.  

When to See a Physiotherapist to Treat Clubfoot or Congenital Talipes Equinovarus (CTEV)? 

This painless birth defect becomes worse with time. Children suffering from this condition learn how to walk using the outer surfaces of their feet and toes. Such abnormal walking patterns can lead to accidents. The skin on the outer borders of their feet may wither away. Over time, the development of corns, wounds, ulcers, etc., make the feet look unsightly. That’s why parents should immediately seek medical advice if they suspect foot-related abnormalities.

Thankfully, in most cases, doctors notice clubfeet right after deliveries. This condition is diagnosed at birth. It can even be diagnosed during pregnancy using ultrasound testing. Doctors may use X-rays of babies inside wombs to assess the positioning of their feet bones. They conduct thorough physical examinations to rule out the risk of this condition and other spinal/muscular diseases. Parents must listen to the doctors about appropriate treatment options. They can also consult pediatric orthopedists and physiotherapists.

Congenital Talipes Equinovarus (CTEV) or Clubfoot - Key Risks and Complications 

There are some common risk factors for this condition:

  • Gender. On average, boys develop CTEV twice as much as girls.
  • Family history. Even if one parent has this condition, the child is likelier to bear it as well.
  • Birth Conditions. Birth defects like spina bifida (spinal cord not developing properly) can trigger other abnormalities in the child’s skeleton, including this condition.
  • Prenatal Environment. Smoking, alcohol consumption, and other bad habits during pregnancy increase the risk of this condition. That’s because such habits reduce the amount of amniotic fluid in the womb during pregnancy.


This condition will not cause any serious problems to children until they start standing, walking, or crawling. Proper physiotherapeutic treatment helps patients walk fairly normally over time. They face relatively minor issues like wearing two differently sized shoes or smaller calf muscles on one of their feet. When not treated, this condition can cause more serious problems like –

  • Abnormal growth of the calf muscles, leading to large calluses on the feet.
  • Arthritis.
  • Self-image issues
  • Inability to walk without walking adjustments.

How to Prevent Getting Congenital Talipes Equinovarus (CTEV)or Clubfoot?

There are no surefire ways of completely preventing the risk of this condition. The least that pregnant mothers can do is not smoke, drink alcohol, etc. Giving the best possible prenatal care is the best solution. Parents must not refrain from talking to genetic counselors. These professionals can recommend helpful prenatal care steps.

Treatments for Congenital Talipes Equinovarus (CTEV) or Clubfoot? 

Physiotherapy is the best and the safest treatment option for this condition. That’s because congenital clubfoot surgeries involve risks like bleeding, infections, and long-term nerve injuries.

  • Physiotherapists create customized exercise plans for children.
  • They correct the curve over time via constant massaging and therapy.
  • If needed, they recommend children wear braces.
  • Top physiotherapists have different methods of treating this condition – the Ponseti method, the French method, etc. All these methods involve stretching at proper angles. They create long-term corrections.
  • Physiotherapists make these processes fun. Children view these life-changing therapy sessions as “playtime.” Parents can make in-house therapy fun as well.

Related Conditions

Here are some other conditions that have similar symptoms to CTEV: amniotic band syndrome, arthrogryposis, hip dysplasia, and spina bifida.

Frequently Asked Questions

1. Is this condition curable?
Yes, but it can come back. Patients who don’t follow the treatment plan and schedule properly often see their feet return to their abnormal positions.
2. Should I give my child a brace?
Yes. By regularly wearing braces, children increase their chances of full recovery.
3. What type of physiotherapists can help?
Look for physiotherapists who specialize in curing this condition.

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