Calcaneovalgus Feet

GENESIS

Calcaneovalgus deformation has a reported frequency of 1.1 per 1000 live births, although some authors indicate that more than 30% of newborns have calcaneovalgus deformity of both feet. It is usually the result of uterine constraint having forced the foot into a dorsiflexed position against the lower leg and is especially common after prolonged breech position with extended legs. Associated congenital hip dislocation occurs in 5–6% of patients with calcaneovalgus and should be searched for in any newborn with this foot deformity. Congenital hip dislocation is more frequent among infants in breech presentation (0.9%), and minor anomalies comprising the breech head deformation complex are also much more frequent with breech presentation, regardless of the mode of delivery. Among infants with frank breech presentation, the extended leg is particularly susceptible to calcaneovalgus foot deformation and genu recurvatum of the knee. Calcaneovalgus is more common in first born infants, with 75% of affected infants being primiparous, and it is much more common in females than in males (4:1). More joint laxity occurs in females, which may explain this finding. There is also a 2.6% frequency of this deformity in parents and siblings by history.