University of Wisconsin–Madison Medical College of Wisconsin

Idiopathic Congenital Talipes Equinovarus in Wisconsin Newborns: Incidence and Associated Risk Factors

Brooke J. Olson, BS; Scott Van Valin, MD; Xue-Cheng Liu, MD, PhD

WMJ. 2022;121(1):36-40

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Introduction: Clubfoot, also known as idiopathic congenital talipes equinovarus, is one of the most common pediatric deformities affecting 1 to 2 in every 1,000 live births. We sought to provide the first known analysis of incidence of clubfoot diagnoses in the most populous region of Wisconsin as well as risk factors associated with the deformity.

Methods: We conducted a retrospective study on children treated for clubfoot at Children’s Wisconsin from January 1, 2004, through December 31, 2018. To examine trends, we performed a linear trend of annual clubfoot births for each county covered as well as the southeastern region of Wisconsin. We also analyzed common risk factors associated with clubfoot.

Results: The study population included 760 clubfoot patients: 497 males and 263 females. Most patients were non-Hispanic/Latino (76.8%) and White (72.2%). A total of 414 patients (54.4%) had no family history of clubfoot, 130 patients (17.1%) had a positive family history of clubfoot, and family history was unknown for 216 patient (28.4%). The southeastern region of Wisconsin contained the largest patient population (n = 523) and, among counties studied, Milwaukee County had the largest patient population (n = 269). Linear trends for Milwaukee County and the southeastern region of Wisconsin showed a statistically significant increase in clubfoot births from 2004 through 2017 (P < 0.001).

Conclusions: In this study of children diagnosed with clubfoot, high population areas showed a statistically significant increase in the number of children affected over time, with a low evidence of family history. This study provides further insight into the possible etiology of clubfoot being influenced by an exogenous, environmental factor.

Author Affiliations: Department of Orthopaedic Surgery, Children’s Wisconsin, Milwaukee, Wisconsin (Van Valin, Liu); Medical College of Wisconsin, Wauwatosa, Wisconsin (Olson, Van Valin, Liu).
Corresponding Author: Scott Van Valin, MD, Department of Orthopaedic Surgery, Children’s Wisconsin, 9000 W Wisconsin Ave, Suite C360, Milwaukee, WI 53224; phone 414.337.7300; email
Acknowledgments: The authors thank Sergery Tarima, PhD, and Alexis Visotcky, MS, for statistical support in the Institute for Health and Equity, Medical College of Wisconsin.
Funding/Support: None declared.
Financial Disclosures: None declared.
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