RT Book, Section
A1 Ebenezer, David S.
A1 Saluan, Paul M.
A2 Usatine, Richard P.
A2 Sabella, Camille
A2 Smith, Mindy Ann
A2 Mayeaux, E.J.
A2 Chumley, Heidi S.
A2 Appachi, Elumalai
SR Print(0)
ID 1114873785
T1 Club Feet
T2 The Color Atlas of Pediatrics
YR 2015
FD 2015
PB McGraw-Hill Education
PP New York, NY
SN 978-0-07-176701-9
LK accesspediatrics.mhmedical.com/content.aspx?aid=1114873785
RD 2024/04/19
AB A  4-day-old  baby  boy  is  brought  to  the  pediatrician’s  office  for  their  first  visit  after  birth.  The  pregnancy  was  full-term  and  uneventful,  except  for  that  the  baby  was  a  breech  birth.  The  baby’s  mother  has  noticed  that  although  both  legs  and  feet  appear  a  little  “curved,”  both  feet  are  almost  “sideways”  and  look  abnormal  (Figure  86-1).  On  examination  of  both  feet  the  hindfoot  is  clearly  inverted,  the  toes  point  medially,  and  the  foot  is  plantar  flexed.  The  deformity  is  somewhat  correctible  by  forcing  the  foot  into  a  more  normal  position,  but  not  completely.  The  baby  does  not  appear  to  be  in  pain.  He  has  no  other  abnormalities,  has  a  normal  neurologic  exam  for  his  age,  and  appears  to  be  otherwise  healthy.  The  child  is  referred  to  a  pediatric  orthopaedic  surgeon,  who  begins  serial  Ponseti  casting  within  one  to  two  weeks.  After  several  weeks  of  weekly  serial  casting,  the  feet  have  a  more  normal  appearance.  The  child  is  then  splinted  full-time  using  a  special  orthosis  for  approximately  three  months,  after  which  he  is  only  splinted  at  night  until  walking  age,  at  which  time  splinting  is  discontinued.  He  has  no  residual  deformity.