Practical Considerations in the Early Treatment of Congenital Talipes Equinovarus

Abstract

Summary An attempt has been made to outline the principles generally followed in the treatment of talipes equinovarus in infancy at the Children's Hospital Medical Center. These methods have held up well over the years. Variations naturally occur from individual preferences. The correction of the equinovarus foot can best be accomplished by starting a detailed and thorough corrective program the day of birth. A large part of the correction should be accomplished within ten days to two weeks and prior to the use of casts. Overcorrection with casts, holding with bivalved casts, and a thoroughly supervised exercise program by the parents is essential. If treatment is delayed and correction cannot be attained in a reasonable time, or if the feet are unusually stiff as in arthrogryposis, surgery should not be unduly postponed, either in heel cord lengthening or medial ligamentous release. Postoperative care must be thorough and long. Otherwise recurrence is common. A child must wear out several pairs of shoes without deformity before supervision can be relaxed.