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Triple arthrodesis
22%
121/538
Soft-tissue releases as necessary
40%
214/538
Tendon transfers to balance the feet in a neutral plantigrade position
12%
62/538
Physical therapy for range of motion and stretching
13%
70/538
Botulinum injections followed by serial casting
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This child has the potential to walk and therefore should have all the contracted structures in the feet released as necessary to place the feet in a plantigrade position for fitting of ankle-foot orthoses. Physical therapy, manipulation, and casting may provide some benefit in a newborn with flexible feet but are not effective in an older infant with rigid clubfeet. Botulinum injections and tendon transfers are of no use because there are no muscles functioning below the knee. Tendon releases are more effective than tendon transfers in children with myelomeningocele.
1.7
(48)
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