Clubfoot and Vertical Talus: Etiology and Clinical Management

Preface
Preface
Contents
Chapter 1: Etiology and Pathogenesis of Clubfoot and Vertical Talus
	Environmental Factors
	Mechanistic Studies of Isolated Clubfoot
	Familial Inheritance of Clubfoot
	Syndromic Versus Isolated Clubfoot
	Expansion of Syndromic Phenotypes to Include Isolated Clubfoot
	PITX1
	Chromosome 17q23.1q23.2 Microdeletions and Microduplications
	HOXC Microdeletions and Missense Mutations in Clubfoot
	Common Genetic Variants in Clubfoot
	PITX1-TBX4-HOXC Mutations and Treatment Resistance
	Vertical Talus
	Implication of Transcriptional Regulators of Early Limb Development in Vertical Talus
	Conclusions
	References
Chapter 2: Classification of Clubfoot
	Introduction
	Clinical Evaluation
		Postural Clubfoot
		Congenital Clubfoot
		Clubfoot Assessment
	Clubfoot Classification
		Ponseti and Smoley Classification System (1963)
		Manes, Costa, and Innao Classification System (1975)
		Harrold and Walker Classification System (1983)
		Catterall Rading System (1991)
		Goldner and Fitch System (1994)
		Dimeglio’s et al. grading System (1995)
		Pirani’s Score (1995)
	Clubfoot Evaluation During Growth
		Carroll’s System for Evaluating Clubfoot Results
	Conclusion
	References
Chapter 3: From the Ponseti Method to the French Method: Research of a Consensus
	Introduction
	Can We Reconcile the French Functional Physical Therapy Method and the Ponseti Method?
	Can the “Hybrid Method” Improve the Outcome of Conservative Treatment?
	Surgery “à La Carte”
	Conclusions
	References
Chapter 4: Treatment of Clubfoot After Walking Age
	Delayed Treatment
	Children Undergoing the Ponseti Method
	Scoring Systems for the Older Child with Clubfoot
	Treatment Challenges
	Ponseti Method Pearls
	Documentation Is Essential
	Complications with Extended Casting
	Bracing Protocol
	Achilles Tendon Tenotomy
	Anterior Tibial Tendon Transfer
	Psychological Aspects
	Surgical Correction
	Future Directions
	References
Chapter 5: Management of Atypical Clubfoot: Challenges and Solutions
	Introduction
	Atypical Clubfoot
	Treatment of Atypical Clubfoot
	Modified Ponseti Technique
	Dobb’s Adaptation Technique
	Imaging
	Consultations
	Bracing Protocol
	Relapse
	Conclusion
	References
Chapter 6: Management of Complex Clubfoot: Challenges and Solutions
	Introduction
	Complex Clubfoot
	Modified Ponseti Technique
	Dobb’s Adaptation Technique
	Imaging
	Consultations
	Bracing Protocol
	Relapse
	References
Chapter 7: Surgical Release for Clubfoot: Principles, Indications, and Evaluation
	Introduction of Comprehensive Surgical Releases
	Surgical Principles and Technique
	Surgical Technique
	Pitfalls and Complications
	Introduction of the Clinical Evaluation of Clubfoot Treatment Outcome
	Physical Examination
	Radiographic Assessment
	Strength Evaluation
	Gait Analysis
	Pedobarography
	Quality of Life Outcomes Self-Assessment
	Future Assessment Tools
	Recent Publications on Evaluation of Clubfoot Treatment Outcome Research
	Conclusion
	References
Chapter 8: Managing Clubfoot Relapses Following Ponseti Method Treatment: Approach Based on Age and Residual Deformity
	Introduction
	Recognition of Relapses
	Principles of Relapse Correction
	Specific Relapse Patient Scenarios
		Recurrent Deformity with Difficulty in Bracewear During the First 6 Months Following Initial Cast Correction (Inadequate Initial Correction Vs. Early Relapse)
		Relapses Before Age 2 1/2 Years
		Early Relapses in Patients Who Are Noncompliant with Bracing
		Dynamic Supination Relapses After Age 2 1/2 Years
		Equinus Relapses/Inadequate Ankle Dorsiflexion
		Relapse Following Prior Tibialis Anterior Tendon Transfer
		Late Relapse After Age 4 Years
		Adduction/Varus Relapse in Older Child with Deformities that Do Not Respond to Serial Manipulation and Casting
		Persistent in Toeing Gait Following Congenital Club Treatment
	Conclusion
	References
Chapter 9: Extensive Soft Tissue Release for Congenital Vertical Talus
	Evolution of Surgery in Congenital Vertical Talus
	Surgical Pathology [1, 19, 20]
		Bone Changes
			Calcaneum
			Talus
			Navicular
			Cuboid
		Ligament Changes
		Muscle Changes
		Joint Changes
	Radiologic Assessment
	Indications for Open Surgery
	Aim of Treatment
		Incisions
		Authors’ Preferred Technique
			Case Example
		Assessment of Results
		Complications
			Immediate
			Early
			Late
		Minimal Invasive Surgery Versus Extensive Release
	References
Chapter 10: Congenital Vertical Talus (Congenital Convex Pes Valgus)
	Introduction
	Etiology
	Pathoanatomy: Congenital Vertical Talus Deformity
		Clinical Features
		Imaging
		Classification
	The Dobbs Method
	Calcaneovalgus
	Oblique Talus
	References
Index