Abstract
In reality, the diagnosis of idopathic clubfoot is never delayed, however, treatment is often delayed in developing countries on account of socio-economic factors. The experience gained from treating children who present late in these countries can be effectively used in more developed countries to treat relapsed clubfeet.
The author considers any treatment for clubfoot offered after a child has started walking as “late treatment”.
The treatment options vary depending on the age of the child and the extent of deformities. The aim of treatment is to obtain a plantigrade foot, retaining the mobility of as many of the tarsal joints as possible.
Accordingly, an outline of treatment is suggested. Soft tissue release operations are recommended for children between 1 and 3 years; soft tissue release operations with or without bony surgery for children between 3 and 5 years; soft tissue release combined with mid tarsal and calcaneal osteotomies and tendon transfers in children between 5 and 14 years. The role of external fixators and distraction techniques advocated by Ilizarov and Joshi, and finally, the role of salvage operations like triple fusion and talectomy are discussed.
The abstracts were prepared by Professor Jegan Krishnan. Correspondence should be addressed to him at the Flinders Medical Centre, Bedford Park 5047, Australia.
