Latent Risk Factors Associated With the Worldwide Occurrence of Congenital Talipes Equinovarus: A Review

Vaishnavi Pandey¹, Ajai Singh^1*, Sabir Ali², Amit Kumar Gond³, Salma Siddiqui⁴, Manish Yadav², Archana Raikwar¹ & Anamika Singh¹

¹Department of Paediatric Orthopaedics, King George’s Medical University, Lucknow, India
²Department of Orthopaedic Surgery, King George’s Medical University, Lucknow, India
³Department of Paediatrics, King George’s Medical University, Lucknow, India
⁴Department of Biochemistry, King George’s Medical University, Lucknow, India

Dr. Ajai Singh, Department of Paediatric Orthopaedics, King George’s Medical University, Lucknow, India.

Keywords: CTEV; Etiology; Genetics; Clubfoot; Congenital; Idiopathic

Abstract

Congenital Talipes Equinovarus (CTEV) is the most frequently reported congenital abnormalities that influence children’s lower limbs in particular. With the prevalence of 1-2 percent per 1000 births worldwide, it occurs mainly in males as opposed to females in a 2:1 ration and is bilateral in about half of cases. The etiology of CTEV can eventually play a role in determining the prognostic and the choice of therapeutic interventions for an individual patient. According to available literature, there was the number of risk factors reported to be associated with its occurrence. However, some of them are popularly known to the world, while some still remained latent. CTEV has been positively linked in the latest literature with the genes of Homeobox family, collagen-family, GLI3, T-Box family, muscle contractile family and apoptotic pathway genes mainly due to its unknown etiology. The recent advances in clubfoot genetics are aimed at examining and explaining the impact of how a demographic, environmental and genetic classification involves itself and how it could result in advanced strategies for individualized therapy. Also, CTEV is thought to be associated during pregnancy with certain maternal environmental interferences, dietary intake, metabolism including mainly folate metabolism, and related activities of the promoter-inducer gene. Hence, the principle objective of this study is to get an overview of all the known and latent risk factors of CTEV, based on the available studies and then update the information as well as hypothesis accordingly.

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