Clubfoot Treatment. Current Concepts
DOI:
https://doi.org/10.1016/j.rccot.2021.01.003Keywords:
clubfoot congenital, clubfeet, treatment outcome, casts surgical, Ponseti, achilles tenotomy, foot abduction braceAbstract
The Ponseti method for the treatment of clubfoot is currently the gold standard due to its excellent results. In contrast, the aesthetic and functional result of feet subjected to extensive surgeries is disappointing in the long term.. The technique of manipulations, casting, tenotomy, and the use of the feet abduction orthosis are explained with detail. Likewise, common errors and other existing alternatives of treatment are also discussed.
Evidence Level: IV
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References
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