• Positional talipes is caused by abnormal pressures compressing the foot while it's developing, as a result of its position in the womb.
• Structural talipes is a more complex condition and probably caused by a combination of factors, such as a genetic predisposition.
• It may also result from a condition called oligohydramnios, where there's a shortage of amniotic fluid around the baby in the womb.
• A genetic predisposition means it tends to run in families.
• There may be associated abnormalities elsewhere in the body, especially with the bones.
• In 50 per cent of cases, both feet are affected.

Talipes Equinovarus (club foot).

In talipes equinovarus, the heel is turned inwards and the whole foot is rolled inwards with the toes pointing upwards. If the cause is positional and the foot is of normal size, the deformity is usually mild and the foot can easily be manipulated into the normal position. In structural talipes equinovarus, the affected foot is shorter and the calf muscles are thinner than normal. The position of the foot is fixed and can't be easily corrected.

Talipes Calcaneovalgus.

In talipes calcaneovalgus, the foot is turned outwards with the toes pointing upwards.

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• School absences due to appointments/ treatment can be common, ensure you have an effective means of enabling the student to catch up and communicating with their peers.
• Environmental changes when pupil is in plaster/ wheelchair
• Clutter free classroom to prevent tripping and easy access in and out of the class.
• Positioning first or last when entering /leaving a room
• Request support from physio/ OT when required
• Toilet access if leg in plaster/extenders
• Supervision and alternative actvities for breaktime/ lunchtime /PE lessons if required or during a period of treatmen
• Physical access in and out of school, around school to key areas eg ICT room, lunch hall

• Positional talipes may not require treatment, although exercises to help the foot regain its natural position may be recommended, a physiotherapist will advise.
• Structural talipes needs prompt treatment, while the baby's tissues are still soft, with manipulation of the foot towards the correct position and methods such as strapping or casting to hold it in place. This may need to be carried out for several months, and may involve putting the feet in splints at night.The Ponseti method, which uses manipulation and casting, followed by boots with a splint to hold the foot in the most effective position.In about 50 per cent of cases, this isn't effective and an operation to straighten the foot may be recommended after the age of six months.