Clubfoot Correction in Walking-age Children: A Review

Children with clubfoot often present after the walking age, especially in low- and middle-income countries where approximately 80% of children with clubfoot are born. With advancing age, there is increased stiffness of the soft tissue structures and decreased remodeling potential of the bones of the foot. Not all clubfeet in older children are rigid—some are flexible and amenable to stretching and conservative treatment. Hence, the initial evaluation of the deformity must include an assessment of correctability. The treatment of clubfoot in the older child is challenging and was traditionally performed using complex soft tissue and bony surgeries, often with poor outcomes in the long term. Recent literature has focused on the role of conservative treatment utilizing Ponseti principles of serial manipulation and casting, combined with limited surgery. The purpose of this review is to report the changing trends in the management of clubfoot in the walking child, to review the current literature regarding various treatment modalities, and to recommend a practical approach to treatment based upon age, inherent flexibility of the foot, available resources, and contextual factors. How to cite this article Penny N, Aroojis A, Mehtani A, et al. Clubfoot Correction in Walking-age Children: A Review. J Foot Ankle Surg (Asia Pacific) 2021;8(3):102–109.