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Date Submitted: 04/17/2012 03:45 PM
Rivera 1
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...