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Management of Atypical Clubfoot: Challenges and Solutions

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Clubfoot and Vertical Talus

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Abstract

Clubfoot is one of the most common orthopedic birth defects. The Ponseti casting method is considered the gold standard for treating clubfoot. The majority of clubfeet occur in isolation and respond well to the traditional Ponseti method. The remaining clubfeet are atypical and usually associated with chromosomal abnormalities, neuromuscular conditions, and/or syndromes. These feet are considered the most difficult to treat and have routinely resulted in extensive surgical interventions as they inconsistently fully correct with the traditional Ponseti method. However, all atypical clubfeet benefit from the modified Ponseti technique. This does not mean that these feet will achieve full correction without some surgical intervention. These feet will gain some benefit from serial casting making any surgery necessary a more thoughtful “a la carte” procedure. Clinical presentation, response to treatment, bracing, and relapse are different in atypical clubfoot, and expectations should be adjusted accordingly. The heterogeneous nature and characteristics of atypical clubfoot are reviewed and detailed in this chapter. The modified treatment protocols and the solutions to the additional challenges encountered in these difficult feet are also discussed.

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Authors and Affiliations

  1. Southern California Foot and Ankle Specialists, Ladera Ranch, CA, USA

    Nitza N. Rodriguez & Robert J. Spencer

  2. Paley Institute, St. Mary’s Medical Center, West Palm Beach, FL, USA

    Matthew B. Dobbs

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  1. Nitza N. Rodriguez
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  2. Robert J. Spencer
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  3. Matthew B. Dobbs
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Editors and Affiliations

  1. Paley Institute, St. Mary's Medical Center, West Palm Beach, FL, USA

    Matthew B. Dobbs

  2. Children's Orthopedic Centre, Mumbai, Maharashtra, India

    Ashok N. Johari

  3. Podiatric Surgery/Orthopedics, Kaiser Permanente Oakland Medical Center, Oakland, CA, USA

    Mitzi L. Williams

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Rodriguez, N.N., Spencer, R.J., Dobbs, M.B. (2023). Management of Atypical Clubfoot: Challenges and Solutions. In: Dobbs, M.B., Johari, A.N., Williams, M.L. (eds) Clubfoot and Vertical Talus. Springer, Cham. https://doi.org/10.1007/978-3-031-34788-7_5

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