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The Journal of Bone and Joint Surgery 78:1624-5 (1996)
© 1996 The Journal of Bone and Joint Surgery, Inc.

Correspondence

Correspondence

Martin Altchek, M.D., P.C., Douglas M. Cooper, M.D. and Frederick R. Dietz, M.D.

TO THE EDITOR:

The article "Treatment of Idiopathic Clubfoot. A Thirty-Year Follow-up Note" (77-A: 1477–1489, Oct. 1995), by Cooper and Dietz, was reassuring to those of us who still treat clubfeet non-operatively. As an orthopaedic surgeon in private practice who has treated clubfoot almost exclusively with casts, or sometimes with Denis Browne splints, for more than forty years and who continues to do so, I have a few comments.

Resection of the Achilles tendon does not, by itself, increase dorsiflexion of the foot. What happens, in my opinion, is that with time a calcaneal deformity develops in the foot, as used to be seen in patients with poliomyelitis who had a weak gastrocnemius-soleus. Although the foot looks better after resection of the Achilles tendon, the strength of push-off is sacrificed. I do not believe that any heel cord can be so contracted that an orthopaedic surgeon cannot stretch it out . . . [Full Text of this Article]


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