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Update on Clubfoot: Etiology and Treatment

Abstract

Although clubfoot is one of the most common congenital abnormalities affecting the lower limb, it remains a challenge not only to understand its genetic origins but also to provide effective long-term treatment. This review provides an update on the etiology of clubfoot as well as current treatment strategies. Understanding the exact genetic etiology of clubfoot may eventually be helpful in determining both prognosis and the selection of appropriate treatment methods in individual patients. The primary treatment goal is to provide long-term correction with a foot that is fully functional and pain-free. To achieve this, a combination of approaches that applies the strengths of several methods (Ponseti method and French method) may be needed. Avoidance of extensive soft-tissue release operations in the primary treatment should be a priority, and the use of surgery for clubfoot correction should be limited to an “a la carte” mode and only after failed conservative methods.

Level of Evidence: Level V, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

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Correspondence to Matthew B. Dobbs MD.

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The authors are supported by NIH NINDS K12 Award (NS01690), the Children’s Discovery Institute, and March of Dimes Basil O’Connor Award (CAG); and by the Shriners Hospital for Children, the Saint Louis Children’s Hospital Foundation, and the Pediatric Orthopaedic Society of North America (MBD).

Each author certifies that his or her institution has approved the human protocol for this investigation and that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.

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Dobbs, M.B., Gurnett, C.A. Update on Clubfoot: Etiology and Treatment. Clin Orthop Relat Res 467, 1146–1153 (2009). https://doi.org/10.1007/s11999-009-0734-9

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Keywords

  • Achilles Tendon
  • Clubfoot
  • Subtalar Joint
  • Ponseti Method
  • Residual Deformity