1. Claw foot is an acquired deformity, occurring most frequently in adolescents and rather more commonly in males than in females.
2. Shortening of the tendo Achillis is not an essential part of the deformity but is present as a complication in about one quarter of the cases.
3. The deformity is such as would be theoretically expected from paralysis of the external plantar nerve.
4. The evidence that temporary paralysis or paresis of this nerve is the cause of the deformity, while not complete, is certainly suggestive.
5. In early cases simple treatment by splints and boots will often avoid the necessity for operation.
6. For moderate cases transplantation of the extensor proprius hallucis is a satisfactory operation.
7. In advanced cases, when portions of the inner four metatarsals are removed, it is advisable to divide the fifth metatarsal at the same time.
(C) 1924 All Rights Reserved.The Journal of Bone and Joint Surgery, Inc.