A method for the treatment of resistant club-foot deformities in children up to six years of age is described. After heel-cord lengthening, occasionally combined with posterior capsulotomy, leverage-wire traction is applied directly to the calcaneus by means of a Kirschner wire and padded footplate, both of which are incorporated in a plaster cast between manipulations. After correction of the equinus and varus deformities of the heel, the wire is removed and subsequent correction is completed by manipulation and plaster casts.
Satisfactory immediate correction was obtained in forty-eight of fifty-two feet in children ranging in age from four months to more than six years.
Thirty-five feet have been followed for from two to nine years, an average follow-up of four years and two months. The results were rated excellent in nine feet, good in thirteen, fair in six, and poor in seven.
The procedure should be used only in children under six years of age with resistant club feet that have not responded to conventional manipulative treatment. Adequate after-care is essential.