Primary treatment of talipes equinovarus.

Our primary club foot therapy consists of a combination of plaster cast manipulation, physiotherapy and surgical correction. The initial plaster cast method of 4 to 6 weeks is followed by a functional mobilisation of the foot. The main aim being the reduction of the malpositioned talus in the ankle mortise. If there is residual deformity surgery is planned after six month. We use the Cincinati approach with the possibility of the dorsal, medial and lateral release enabling a correction of the hind-, mid- and forefoot. The main part of postoperative care is seen in the functional rehabilitation of the foot by physiotherapy, in order to achieve a cosmetic foot with good functions. Physiotherapy is advised until the child enters school in order to preserve function and form into adult life. A high frequency of satisfactory results can be expected using this protocol.