Evidence from the Health Protection Agency (HPA) shows that the number of cases of invasive pneumococcal disease is falling since the introduction of the pneumococcal vaccine.
A baby was born at term following an uneventful pregnancy. When the baby was examined by a midwife it was found to have an unusual appearance of its feet. The baby was otherwise well.
The baby's feet.
Q1. What is the diagnosis?
Congenital talipes equinovarus (clubfoot).
Congenital talipes equinovarus or clubfoot is a complex congenital deformity of the foot and ankle. Talipes is derived from the latin talus (ankle) and pes (foot). Equino means "like a horse" and varus is a term for the inward angulation of the distal segment of a bone or joint. The opposite of varus is valgus (see Wikipedia's entry for varus for more information). Clubfoot is relatively common with an incidence of between 1 - 2 per 1000 births (Wallender at al. Incidence of congenital clubfoot in Sweden. Acta Orthopaedica 2006;77(6):847–852). Most cases are idiopathic but there are a variety of associations including oligohydramnios, spina bifida, and cerebral palsy. A variety of treatments are available including straping, surgery and the so-called Ponseti method of manipulation and casting.
