Nonsurgical treatment of congenital clubfoot with manipulation, cast, and modified Denis Browne splint.

Abstract

Between 1974 and 1988, 113 congenital clubfeet in 76 children were consecutively treated by using a modified Denis Browne splint with an aluminum crossbar between a pair of plastic shoe inserts after a few manipulations and a corrective cast. Splintage was followed by surgery in 41 (36%) feet. Sixty-nine feet that did not undergo surgery were evaluated after an average follow-up period of 12 years. Sixty-six (95%) feet were excellent or good, according to the McKay rating system. The success rate of this treatment was 60% when the 41 feet receiving surgery and the three feet with fair or poor outcome were evaluated as failures. The success rate was 42% in severely deformed feet, 70% in moderately deformed feet, and 100% in mildly deformed feet. This treatment was effective for congenital clubfoot with mild or moderate deformity and was sometimes effective for severe deformity.