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Clubfoot

Authors: Philippe, Wicart;

Clubfoot

Abstract

Clubfoot. The clubfoot is secondary to an early trouble of foot development at the end of the first trimester of pregnancy. This explains the structural disorders which concern all the tissues of mid-hindfoot and the leg and the tendency to relapse during growth. The diagnostic is triple: positive, etiological and scoring classification. A clinical and radiological checking is mandatory until the end of growth. The treatment is conservative combining casts, splints and physiotherapy. The indication of Achilles tenotomy, not systematic, is evaluated on clinical and radiological criteria. Nocturnal orthosis until at least 5 years old is one of the most important therapeutic aspects. A soft tissue release is indicated in case of a significant deformity. Minor « enhancement procedures » as tibialis anterior tendon lenghtening or transfer, may be indicated for punctual flaw. The results in adults are good in 80% of cases, and inversely proportional to heavy treatments during childhood including surgeries.

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