Description
The aim of club foot surgery should be to achieve a complete and lasting correction with the minimum of intervention. We will only be able to improve on current practice by a greater understanding of the pathologenesis of club feet. The surgeons should try to achieve complete correction of all components of the deformity at the first operation. Provided that this has been achieved, then if recurrence occurs it is likely to be due to an underlying neuromuscular condition causing muscle imbalance. For the dynamic deformity, a split tibialis anterior tendon transfer is recommended. With a fixed deformity, the Ilizarov technigue has definite advantages over conventional surgery, particulary with its ability to convert a fixed into a dynamic deformity and the lower risk of creating a calcaneus deformity. Future, developments will include refinements of the Ilizarov technique and wider teaching of these methods to make them more readily accessible to paediatric orthopaedic surgeons.
