Management of resistant, relapsed, and neglected clubfoot

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From virgin to neglected clubfoot, situations are variable and strategies different when surgery is necessary. If conservative treatment is no longer effective, surgery should be considered. Mini-invasive surgery is a complementary procedure to nonoperative treatment (surgery “à la carte”). Conservative treatment reduces but does not eliminate the need for mini-invasive surgical procedures. Resistant clubfeet are those not fully respondent to standard methods of orthopaedic treatment. Relapsed clubfeet are those patients with a history of soft-tissue releases followed by a rapid relapse. Neglected clubfeet are those resulting from failure to treat the deformity at birth or in early infancy or to provide adequate treatment during infancy and early childhood. Relapsed and neglected clubfeet are some of the most difficult pediatric orthopaedic problems to treat. Every effort should be made to prevent them from occurring. The purpose of this work is to present an overview of treatment options for resistant, relapsed, and neglected clubfoot.

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