Clubfoot Correction in Walking-age Children: A Review
2021
Children with clubfoot often present after the walking age, especially in low- and
middle-income countries where approximately 80% of children with clubfoot are born.
With advancing age, there is increased stiffness of the soft tissue structures and
decreased remodeling potential of the bones of the foot. Not all clubfeet in older
children are rigid—some are flexible and amenable to stretching and conservative treatment.
Hence, the initial evaluation of the deformity must include an assessment of correctability.
The treatment of clubfoot in the older child is challenging and was traditionally
performed using complex soft tissue and bony surgeries, often with poor outcomes in
the long term. Recent literature has focused on the role of conservative treatment
utilizing Ponseti principles of serial manipulation and casting, combined with limited
surgery. The purpose of this review is to report the changing trends in the management
of clubfoot in the walking child, to review the current literature regarding various
treatment modalities, and to recommend a practical approach to treatment based upon
age, inherent flexibility of the foot, available resources, and contextual factors.
How to cite this article Penny N, Aroojis A, Mehtani A, et al. Clubfoot Correction in Walking-age Children: A Review. J Foot Ankle Surg (Asia Pacific)
2021;8(3):102–109.
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