Surgical Management of Clubfoot

Introduction

Clubfoot deformity, while one of the most familiar congenital orthopedic conditions presenting for early intervention, can pose numerous treatment challenges to even the seasoned pediatric orthopedic surgeon. Though nonoperative management with serial casting is currently the gold standard of care during infancy, surgical intervention is still occasionally required to obtain a painless, functional, and plantigrade foot for recurrent or resistant deformities. Although there is no standard surgical algorithm for the relapsed or resistant clubfoot deformity, it is widely accepted that, even in these situations, treatment begins in the clinic with an effort to reduce the need or extent of surgical intervention required via serial casting. Surgical intervention for clubfeet should always be performed with mindfulness of the potential of further recurrence, as well as stiffness and pain that any surgery, but especially intra-articular surgery, can create in what are oftentimes already stiff feet.