Update on Clubfoot: Etiology and Treatment

Does Strict Adherence to the Ponseti Method Improve Isolated Clubfoot Treatment Outcomes? A Two-institution Review

“…Conservative treatment attempts to correct the deformity such that the foot is functional, pain-free, flexible, and able to fit in regular shoes [22,23]. The Ponseti method has become the gold standard in isolated clubfoot care [7,20,25]. This approach consists of specific serial manipulations, casting and tenotomy of the Achilles tendon, followed by abduction bracing of the affected foot or feet until the child is 2 to 4 years old.…”

Club foot in association with the 22q11.2 deletion syndrome: An observational study

“…It has been related to the intra‐uterine position, environmental factors such as smoking, or abnormal muscle, soft tissue, bone and vascular malformations (Dobbs & Gurnett, 2009; Horn & Davidson, 2010). Moreover, there is definitely a genetic component regarding the development of club foot within 22q11.2DS: multiple genes (e.g., PITX1 , TBX4 ) are associated with the development of club foot and within identical twins there is 33% concordance (Basit & Khoshhal, 2018; Horn & Davidson, 2010).…”

“…“True club foot” needs treatment (either conservative or surgical) and therefore, in order to prevent false positive cases (e.g., patients with another (congenital) malformation of the foot), we only included patients whom had proof of treatment of the club foot and thus the clinical diagnosis of club foot (Dobbs & Gurnett, 2009; Horn & Davidson, 2010; Werler et al, 2013). …”

“…Cerebral palsy and spina bifida are known to have a strong association with club foot and therefore the 22q11.2DS cases were screened for these anomalies (Dobbs & Gurnett, 2009; Werler et al, 2013). The 22q11.2DS patients with a club foot were compared with the non‐club foot 22q11.2DS patients with respect to the presence of CHD and cleft palate.…”

“…Club foot (Figures 1 and 2), can be identifiable in utero (Figure 3) and it contains four characteristic features which can be remembered through the acronym CAVE: cavus (a high medial longitudinal arch), forefoot adductus, hindfoot varus, and hindfoot equinus (Figure 1) (Dobbs & Gurnett, 2009; Horn & Davidson, 2010; Werler et al, 2013). The prevalence of congenital isolated club foot in the general population differs among multiple ethnic populations, but is approximately 1.2–6 per 1,000 individuals.…”