Patho-anatomy of Pes Equinovarus Deformity
Patho-anatomy of Pes Equinovarus Deformity: Navicular bone articulates with the anterior facet of the talus in normal foot. However, navicular articulates with the medial side of talus in pes equinovarus deformity. In severe clubfoot cases, navicular may even have an articulation with medial malleolus. The sooft tissue structures in the medial part of the foot like posterior tibial tendon sheath, calcneonavicular ligament are thickhened in pes equinovarus patients. Calcaneofibular ligament located posterolaterally is shorthened and thickhened in most clubfoot cases.
Deep skin creases located posteriorly and medially are commonly seen in Pes equinovarus.As shown in the picture, eight talus with clubfoot shows deviation medially.
It is extremely important to understand the pathoanotomy of clubfoot to be able to plan the treatment. Manipulations and serial castings can be performed correctly to reduce the joints only with pompt pathoanotomy knowledge.