The results of treatment in sixty-seven patients with a total of ninety-four severe congenital club feet were evaluated five to thirteen years after the initial treatment. The primary treatment consisted in the application of several plaster casts changed frequently for an average period of 9.5 weeks. In many instances a subcutaneous tendo achillis tenotomy was performed in the primary treatment to obtain a complete correction of the equinus deformity. Denis Browne splints were used in the follow-up care in all patients.
In fifty-three feet the deformity recurred and required further treatment. The recurrences of the equinus deformity were usually mild and responded to conservative treatment. Only seven tendo achillis lengthening operations were performed. A transfer of the anterior tibial tendon to the dorsolateral aspect of the foot was performed in thirty-nine feet to prevent further recurrences of the heel varus deformity. Medial release operations were necessary in only three feet. In no case was bone surgery performed.
The results in 71 per cent of the feet were good; in 28 per cent a slight residual deformity persisted; and in one foot a poor result was obtained.
From the Department of Orthopedic Surgery, State University of Iowa, Iowa City