Skip to main content
SpringerLink
Log in

Management of Clubfoot

  • Reference work entry
  • First Online:
European Surgical Orthopaedics and Traumatology

Abstract

Congenital clubfoot is charaterized by a malalignement of talocalcaneal, talonavicular and calcaneocuboid joints, the cause of which is still unknown. Its management must begin shortly after birth. During the last years, The Ponseti method has been spreading throughout the world, and its protocol of management followed almost everywhere. It consists of manipulation followed by a toe-to-groin plaster cast application every 5–7 days (usually, 4–5 casts). A percutaneous tenotomy of the Achilles tendon is required in about 85% of the cases. A modified Danis-Browne splint is thereafter applied up to 3-4 years of age. Relapse is the re-appearance of clubfoot deformity after full correction, the highest incidence occurring between 1.5 and 4 years of age. Tibialis anterior tendon transfer to the third cuneiform is indicated in relapsing cases. Relapse must be differentiated from mal-treated clubfeet in which the original deformity has never been fully corrected. Mal-treated cases are difficult to treat, and their management depends on the age at diagnosis.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 649.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 949.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Codivilla A. Sulla cura del piede equino varo congenito. Nuovo metodo di cura cruenta. Arch Chir Ortop. 1906;23:254–66 (Italian).

    Google Scholar 

  2. Erlacher P. Die Techik des orthopädischen Eingriffs. Vienna: Springer; 1928 (German).

    Book  Google Scholar 

  3. Vulpius O. Die Behandlung der angeborenen Klumpfüsse. Deutech Med Woch. 1923;13:40–51 (German).

    Google Scholar 

  4. Jones R, lowett RW. Orthopaedic surgery. London: Oxford University Press; 1929.

    Google Scholar 

  5. Ombrédanne L. Precis clinique et opératoire de chirurgie infantile. Paris: Masson; 1932.

    Google Scholar 

  6. Marino-Zuco C. Trattamento del piede torto congenito. Roma: Arte della Stampa; 1934 (Italian).

    Google Scholar 

  7. Kite JH. Non-operative treatment of congenital clubfeet; a review of one hundred cases. South Med J. 1930;23:337–51.

    Article  Google Scholar 

  8. Fripp AT, Shaw NE. Club-foot. Edimburg, London: Livingstone; 1967.

    Google Scholar 

  9. Ponseti IV, Smoley EN. Congenital club-foot: the results of treatment. J Bone Joint Surg Am. 1963;45A:261–75.

    Google Scholar 

  10. Turco VJ. Resistant congenital clubfoot treated by one stage posteromedial release with internal fixation. A follow-up report of a fifteen years experience. J Bone Joint Surg Am. 1979;61A:805–14.

    Google Scholar 

  11. Brockman EP. Modern methods of treatment of club-foot. Br Med J. 1937;2:572–8.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  12. Crawford AH, Marxen JL, Osterfeld DL. The Cincinnati incision: a comprehensive approach for surgical procedures of the foot and ankle in childhood. J Bone Joint Surg Am. 1982;64A:1335–58.

    Google Scholar 

  13. McKay DW. New concept of and approach to clubfoot treatment – section II: correction of the clubfoot. J Pediatr Orthop. 1983;3:10–21.

    Article  CAS  PubMed  Google Scholar 

  14. Laaveg SJ, Ponseti IV. Long-term results of treatment of congenital club foot. J Pediatr Orthop. 1990; 10:109–19.

    Article  Google Scholar 

  15. Ryöppy S, Sairanen H. Neonatal operative treatment of club foot. J Bone Joint Surg Am. 1983;65B:320–5.

    Google Scholar 

  16. Pous JG, Di Meglio A. Neonatal surgery in clubfoot. Orthop Clin North Am. 1978;9:233–40.

    CAS  PubMed  Google Scholar 

  17. Dimeglio A. Le traitment chirurgicale du pied bot varus equin. In: Encyclopedie medico-chirurgicale. Paris: Tome Techiniques Chirurgicales; 1977.

    Google Scholar 

  18. Epeldegui T. Conceptos y controversias sobre el pie zambo. Madrid: Vincente; 1993 (Espagnol).

    Google Scholar 

  19. Bensahel H, Guillaume A, Czukonyi Z, Themar-Noel C. The intimacy of clubfoot: the ways of functional treatment. J Pediatr Orthop B. 1994;3:155–60.

    Article  Google Scholar 

  20. Ippolito E, Ponseti IV. Congenital clubfoot in human fetus. J Bone Joint Surg Am. 1980;62A:8–16.

    Google Scholar 

  21. Huson A. Een ontleedkundig-functioneel anatomisch onderzoek van de voetwortle (An anatomical and functional study of the tarsus) [thesis]. Luctor et Emergo: University of Leichen; 1961.

    Google Scholar 

  22. Ponseti IV. Congenital clubfoot: fundamentals and treatment. New York: Oxford University; 1996.

    Google Scholar 

  23. Dobbs MB, Gordon J, Walton T, Schoenecker PL. Bleeding complications following percutaneous tendoachilles tenotomy in the treatment of clubfoot deformity. J Pediatr Orthop. 2004;24:353–7.

    Article  PubMed  Google Scholar 

  24. Ponseti IV, Zhivkov M, Davis N, Sinclair M, Dobbs MB, Morcuende JA. Treatment of the complex idiopathic clubfoot. Clin Orthop. 2006;451:171–6.

    Article  PubMed  Google Scholar 

  25. Ponseti IV. Common errors in the treatment of congenital clubfoot. Int Orthop. 1997;21:137–41.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  26. Cooper MD, Dietz FR. Treatment of idiopathic clubfoot. A thirty-year follow-up note. J Bone Joint Surg Am. 1995;77A:1477–89.

    Google Scholar 

  27. Ippolito E, Farsetti P, Caterini R, Tudisco C. Long-term comparative results in patients with congenital clubfoot treated with two different protocols. J Bone Joint Surg Am. 2003;85A:1286–94.

    Google Scholar 

  28. Dobbs MB, Nunley R, Schoenecker PL. Long term follow-up of patients with clubfeet treated with extensive soft-tissue release. J Bone Joint Surg Am. 2006;88A:986–96.

    Article  Google Scholar 

  29. Morcuende JA, Dolan LA, Dietz FR, Ponseti IV. Radical reduction in the rate of extensive corrective surgery for clubfoot using the Ponseti method. Pediatrics. 2004;113:376–80.

    Article  PubMed  Google Scholar 

  30. Zionts LE, Zhao G, Hitchcock K, Maewal LJ, Ebramzadeh E. Has the rate of extensive surgery to treat idiopathic clubfoot declined in the United States? J Bone Joint Surg Am. 2010;92A:882–9.

    Article  Google Scholar 

  31. Uglow MG, Clarke NMP. Relapse in staged surgery for congenital talipes equinovarus. J Bone Joint Surg Am. 2000;82B:739–43.

    Article  Google Scholar 

  32. Ippolito E, Ricciardi-Pollini PT, Tudisco C, Ronconi P. The treatment of relapsing club foot by trasposition of tibialis anterior. Ital J Orthop Traumatol. 1985;11:171–7.

    CAS  PubMed  Google Scholar 

  33. Farsetti P, Caterini R, Potenza V, Mancini F, Ippolito E. Anterior tibial tendon transfer in relapsing congenital clubfoot. Long-term follow–up study of two series of patients treated with a different protocol. J Pediatr Orthop. 2006;26:83–90.

    Article  PubMed  Google Scholar 

  34. Bor N, Herzenberg J, Frick SL. Ponseti management of clubfoot in older infants. Clin Orthop. 2006;444:224–8.

    Article  PubMed  Google Scholar 

  35. Nogueira MP, Battle AM, Gomes Alves C. Is it possible to treat recurrent clubfoot with The Ponseti technique after postero-medial release? Clin Orthop. 2009;467:1298–305.

    Article  PubMed Central  PubMed  Google Scholar 

  36. Ippolito E, Fraracci L, Farsetti P, De Maio F. Validity of the anteroposterior talo-calcaneal angle to assess congenital clubfoot correction. Am J Roentgenol. 2004;182:1279–82.

    Article  CAS  Google Scholar 

  37. Hatt RN, Lamphier TA. Triple hemisection: a simplified procedure for lengthening the Achilles tendon. N Engl J Med. 1947;236:166–9.

    Article  CAS  PubMed  Google Scholar 

  38. Legaspi J, Li YH, Chow W, Leong JC. Talectomy in patients with recurrent deformity in clubfoot: a long-term follow-up study. J Bone Joint Surg Am. 2001;83B:384–7.

    Article  Google Scholar 

  39. Lourenço AF, Morcuende JA. Correction of neglected idiopathic clubfoot by the Ponseti method. J Bone Joint Surg Am. 2007;89B:378–81.

    Article  Google Scholar 

  40. Herold HZ, Torok G. Surgical correction of neglected clubfoot in the older child and adult. J Bone Joint Surg Am. 1973;55A:1385–95.

    Google Scholar 

  41. Grill F, Franke J. The Ilizarov distractor for the correction of relapsed or neglected Clubfoot. J Bone Joint Surg Am. 1987;69B:593–7.

    Google Scholar 

  42. Choi IH, Yang MS, Chung CY, Cho TJ, Sohn YJ. Treatment of recurrent arthrogrypotic clubfeet in children by Ilizarov method: a preliminary report. J Bone Joint Surg Am. 2001;83B:731–7.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, University of Rome “Tor Vergata”, Rome, Italy

    Ernesto Ippolito, Pasquale Farsetti & Matteo Benedetti Valentini

Authors
  1. Ernesto Ippolito
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Pasquale Farsetti
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Matteo Benedetti Valentini
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ernesto Ippolito .

Editor information

Editors and Affiliations

  1. Royal National Orthopaedic Hospital, Stanmore, United Kingdom

    George Bentley

Rights and permissions

Reprints and permissions

Copyright information

© 2014 EFORT

About this entry

Cite this entry

Ippolito, E., Farsetti, P., Valentini, M.B. (2014). Management of Clubfoot. In: Bentley, G. (eds) European Surgical Orthopaedics and Traumatology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-34746-7_157

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-34746-7_157

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-34745-0

  • Online ISBN: 978-3-642-34746-7

  • eBook Packages: MedicineReference Module Medicine

Publish with us

Policies and ethics

Search

Navigation