Cadaveric Dissection of Adult Neglected Talipes Equinovarus

Congenital talipes equinovarus is a musculoskeletal deformity causing foot disability with plantar flexed, inverted and adducted foot. The deformities associated with club foot must be corrected at an early age to prevent long term residual disabilities.

In this case, we describe a rare anatomical variation of the neglected adult club foot, which was noticed during routine dissection of lower limb for IMBBS in AIIMS, Mangalagiri. The adult neglected club foot was dissected to identify the exact soft tissue and bony abnormalities involved in the deformity. The plantar fascia, long flexor tendons of foot, ligaments of tarsal joints and thick fibrous aponeurotic sheaths were taut and causing the deformity was identified. The talar head was displaced medially subluxating the navicle and cuboid inferiorly misaligning the talocalcaneo navicular joint and calcaneocuboid joint. In addition, deep arches of foot were prominent with stout metatarsals in fixed hyperextended deformity.

The knowledge about the bony and soft-tissue abnormalities can be helpful for an orthopedician in the surgical correction of club foot in adults and can take precautions in preventing relapse as it requires soft-tissue releases, tendon lengthening procedures, and osteotomies in neglected club foot.