Idiopathic clubfoot

Purpose of review: The goal of this review is to provide the orthopaedic surgeon with a comprehensive review of significant contributions to the orthopaedic literature from 2003 to 2005 on the subject of idiopathic clubfoot. This body of information should allow the surgeon to improve the understanding, evaluation, and treatment of this deformity. Recent findings: Advances in the understanding of the causes of idiopathic clubfoot are developing, although no definitive information is yet available. Improvements in the classification and more precise descriptions of the terminology are helping the orthopaedic community compare results. Much of the current literature focuses on validating the largely nonoperative manipulation, casting, and bracing method as described by Ignacio Ponseti. Despite improvements in the manipulative treatments, the guidelines for the management of clubfeet that have relapsed, were neglected, or have not responded to failed treatment continue to evolve. Summary: Although the cause of idiopathic clubfoot remains elusive, a general trend toward a reduction in the need for extensive surgical releases is evident by the current literature. Outcomes are generally better in patients successfully treated by nonoperative methods than in those requiring extensive surgery.