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CONSERVATIVE MANAGEMENT OF CONGENITAL CLUBFOOT DEFORMITY

RAYMOND F. KUHLMANN, M.D.
AMA Am J Dis Child. 1954;87(4):440-447. doi:10.1001/archpedi.1954.02050090428003.
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THE PROBLEM of adequate management of the uncomplicated case of congenital talipes equinovarus persists, in spite of 2,000 years of treatment. Although it was described and treated in the time of Hippocrates, the task of effective treatment remains our heritage.1

Corrective appliances, as illustrated by Scarpa's brace and shoe,2 gradually disappeared in favor of forceful manipulations under anesthesia. As the tools of violent manipulations lost their popularity and surgery was resorted to more vigorously, the effectiveness of gentle persistent manipulation by properly applied corrective clubfoot casts was conclusively presented by J. H. Kite, in 1930.3

Denis Browne published his method of treatment by active splinting in 1934.4 The apparatus, consisting of two foot splints bound together by a crossbar, was originally devised to combat the internal tibial torsion often accompanying the other clubfoot elements. It was used as a retention splint after violent manipulation whereby the foot

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