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Congenital clubfoot, or talipes equinovarus, is a complex deformity that is readily apparent at birth and affects the muscles, ligaments, bones and joints of the developing foot and ankle. The ankle is rotated downward and the toes point inward towards the opposite leg. All foot bones are usually present, but are out of normal alignment. All of the foot and leg muscles are also present, but some are smaller and weaker than normal. Tendons and ligaments are contracted, especially behind the ankle and along the instep.