What’s the latest thinking about surgery to correct a clubfoot deformity? We had a child who had this surgery about 10 years ago. It turned out fine but there was a lot of question then about whether or not it was even necessary.

There is still quite a bit of debate and controversy over the treatment of clubfoot (also known as talipes equinovarus). Should surgery be done at all? When’s the best time to do it? What type of incision should be used? Should the leg be immobilized in a cast right away and for how long?

Some surgeons correct the foot deformity but wait a week to put a cast on the leg. They do use a removable splint to hold the foot in a neutral position. This allows them to check the wound for infection, swelling, and any other problems with healing.

Others prefer to use a leg cast to hold the foot firmly in place. The cast is removed and replaced at regular intervals until healing takes place. This allows the surgeon to periodically check the wound site and gradually move the foot into a neutral position. The skin doesn’t get pulled quite so much so quickly with the serial casting.

Some of the decision-making depends on the age of the child when the surgery takes place. There can be a wide range from infancy to adolescence. Some children only have the clubfoot deformity. Others have other conditions as well such as hip dysplasia, spina bifida, or arthrogryposis. When and how the surgery is done may vary based on these other factors.