Aetiology

There is no clear cause for talipes equinovarus. Credible theories include:

• microvascular disorder during in utero development of the foot
• defective ossification of the talus and other bones - the germ plasm defect theory
• abnormal tendon and ligament attachments or contracture
• external compression in utero, e.g. from oligohydramnios or constriction rings
• neuromuscular dysfunction, e.g. calf muscle denervation, delayed muscle maturation

If the condition is not corrected early, secondary growth changes occur in the soft bones of childhood. These changes cause the permanent deformity seen in adults.