The document summarizes the pathoanatomy of clubfoot deformity. Key findings include: 1) Bones are smaller and angulated, with the talus facing down and medially. The calcaneum is small and concave. 2) Joint deformities include equinus at the ankle, inversion primarily at the subtalar joint, and forefoot adduction and cavus at the midtarsal joints. 3) Muscles of the calf are underdeveloped and the posterior and medial muscle-tendon units are contracted, including the tibialis posterior, flexor digitorum longus, and flexor hallucis longus.

1. PATHOANATOMY
Made by –
Dr. Kanwal Bajaj
IX Sem

2. DEFORMITY IN BONES
1.Bones are smaller than normal
2.Neck of the talus is angulated 
Talus faces down and medially
3.Calcaneum is small, concave
medially

3. DEFORMITY IN JOINTS
1. EQUINUS:
• Primarily at ankle joint
• Other tarsal joints also contribute
2. INVERSION:
• Primarily at sub-talar joint
• Inverted calcaneum takes the whole foot  Sole
faces medially
3. FOREFOOT ADDUCTION :
• At mid-tarsal joints (Mainly talonavicular joint)
4. FOREFOOT CAVUS :
• d/t Excessive arching of foot at mid-tarsal joints

4. MUSCLES AND TENDON
• Muscles of calf are under developed 
following muscles-tendon units are
contracted:
1. POSTERIORLY  Tendoachilles
2. MEDIALLY (3 Muscles )
• Tibialis posterior
• Flexor digitorum longus (FDL)
• Flexor hallucis longus(FHL)

5. CAPSULES AND LIGAMENTS
• All ligamentous structures on postero-medial aspect of
foot are shorten
• Structures affected are:
1. POSTERIOR (3 Structures) :-
A.Posterior capsule of ankle joint
B. Posterior capsule of sub-talar joint
C. Posterior talo-fibular and calcaneo-fibular
ligament
2. MEDIAL (3 Ligaments ) :-
A. Talo-navicular ligament
B. Spring ligament
C. Deltoid ligament

6. 3.PLANTAR:-
A. Plantar fascia
B.Plantar ligaments
4.OTHERS :-
A. Interosseous ligaments
between talus and calcaneum

7. SKIN
• It develops adaptive shortening
on medial side of sole
• Deep creases present on medial
side
• Dimples on lateral aspect of ankle
and mid foot

8. SECONDARY CHANGES
• Occurs if child starts walking on
deformed feet
• Weight bearing exaggerates
deformity
• Callosities and bursae develop
over bony prominences on lateral
side of foot

9. THANK YOU