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Clubfoot second treatment phase

Clubfoot second treatment phase

Surgery

Once the foot has reached the desired position, the second phase involves a minor surgical procedure referred to as tenotomy of the Achilles tendon. This involves cutting the Achilles tendon to allow the heel (calcaneum) to drop down to its correct anatomical position. Once the tenotomy is complete, your child will wear a new cast for at least three weeks. This last cast greatly accentuates the foot’s external rotation position (the foot will be really turned outward and this is normal). The foot will then no longer be pointed downward but rather upward, enabling the Achilles tendon to lengthen naturally, heal and re-attach. The ability of babies to recover quickly rests on the fact that the healing process is completed at the end of just a few weeks. The casts are finally removed and all that remains is a small, barely visible, scar about 1 cm long.

In most cases, a local anaesthetic is used during surgery in the sterile environment of the operating theater. However, you cannot be present during your child’s surgery. This operating room procedure is designed to decrease risks of infection and to offer a calm environment optimal for the surgery’s success. A nurse will take care of your child throughout the surgical procedure. She will then give you surgery-related details and advice.

If the Ponseti method is initiated well after the first weeks of life, the surgeon may opt to perform the surgery under general anesthesia.

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Ponseti method and treatment phases, continued