Based on a review of thirty-seven feet of twenty-nine patients with claw-foot deformity due to several causes, four stages of the deformity were identified as well as the indications for specific operative procedures when non-operative treatment failed. Transfer of the long toe extensors to their respective metatarsal necks and fusion of the interphalangeal joints was performed after other appropriate procedures to correct tight posterior structures (heel cord and posterior capsule), fixed cavus, or other deformity. Complete correction of the deformity except for mild residual cock-up in three feet was obtained.