In the pathoanatomy of untreated congenital talipes equinovarus, the midtarsal deformity is best described as which bony relationship?
- A Navicular displaced medially and plantarward on the head of the talus ✓
- B Navicular displaced dorsally on the head of the talus
- C Calcaneus displaced dorsally under the talus
- D Cuboid displaced laterally on the calcaneocuboid joint
Correct answer: A. Navicular displaced medially and plantarward on the head of the talus
Explanation
The key midtarsal lesion in clubfoot is medial and plantar subluxation of the navicular on the talar head, so the forefoot adducts and the talus becomes relatively uncovered medially. This, together with cavus from plantarflexion of the first ray, hindfoot varus from the subtalar complex, and equinus from the posterior structures, defines the deformity. Dorsal displacement of the navicular describes congenital vertical talus instead.
Reference: Tachdjian's Pediatric Orthopaedics, 5th ed.
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