Clubfoot, a History

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Freida Rivera

Mr. Toye

Composition

2 October 2011

Clubfoot Treatment

Clubfoot is one of the most common problems in pediatric orthopaedics. The threedimensional deformity is characterized with high arches, drawn up heels, pointed down toes and

a foot twisted towards the other foot. Records of clubfoot have been found in Egyptian tomb

paintings dating as early as 1000 B.C. Due to lack of understanding the functional anatomy of

the foot in the deformity clubfoot treatment is extremely controversial. The choice between

Invasive (surgical) and non-invasive treatment¹ has been debated by many specialist. However it

has only been recently, with the help of case studies and research collaborations that specialist

are now concluding non-invasive treatments may be the best route.

Every time a surgical method has been adopted, serious and dangerous side-effects have

followed. Dobbs’, Morcuende’s, Gurnett’s, Ponseti’s Treatment of Idiopathic Clubfoot: An

Historical Review underlines how the introduction of aseptic and anesthesia techniques paved the

way for clubfoot surgical treatments. Among one of the first treatments was the release of soft

tissue³, and the division of the Achilles tendon by Phelps² in 1891, however as the practice

evolved Brockman² (1930) argued, “that widespread soft tissue release lead to the formation of

extensive fibrous tissue” (59- 64), he also noticed from operating on the Achillies³ that “ the

operated feet were left stiff and immobile and he eventually abandoned this procedure”(59-64).

Regardless how often a new surgical treatment method is developed, the method has always been

brought to questioning by the broadened understanding of the deformity. For example, in 1922

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Dunn² practiced the transfer of the anterior tendon in order to prevent relapse yet in 1958 Barr²

contradicted him as he discovered that the tendon should not be transferred as it resulted in a

muscle imbalance.

As the...