Clinical Orthopaedics and Related Research

, Volume 467, Issue 5, pp 1206–1213

Gait Analysis after Initial Nonoperative Treatment for Clubfeet: Intermediate Term Followup at Age 5

Symposium: Clubfoot: Etiology and Treatment

DOI: 10.1007/s11999-008-0702-9

Cite this article as:
Karol, L.A., Jeans, K. & ElHawary, R. Clin Orthop Relat Res (2009) 467: 1206. doi:10.1007/s11999-008-0702-9


We conducted gait analysis following initial nonoperative clubfoot treatment to compare lower extremity kinematic (eg, ankle motion) and kinetic (eg, ankle power) characteristics between patients treated as infants with Ponseti casting or French physical therapy. This is a followup report of gait characteristics at age 5 years in patients who had previously been tested at age 2 years. One hundred-twenty five clubfeet in 90 patients (34 feet only Ponseti treatment, 40 only French PT, and 51 feet initial nonoperative treatment followed by surgery) were included. The gait characteristics were compared to those of age-matched normal control subjects. Ankle equinus during gait occurred in 5% of feet treated with the French method and none of those treated by the Ponseti method. Increased stance phase ankle dorsiflexion persisted in 24% of feet treated by the Ponseti method. Intoeing was seen in 1/3 of both the French and Ponseti methods. Ankle push-off power was decreased compared to normal in patients treated by both methods, and even more so in operated feet. The presence or absence of Achilles tenotomy did not affect ankle power. Gait characteristics of feet that did not have surgery and maintained correction were superior to those of operated feet.

Copyright information

© The Association of Bone and Joint Surgeons 2009

Authors and Affiliations

  1. 1.Texas Scottish Rite Hospital for ChildrenDallasUSA
  2. 2.Isaac Walton Killam Health CentreHalifaxCanada