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Congenital talipes equinovarus or clubfoot is one of the oldest known congenital deformities, and its diagnosis and treatment date back to the time of Hippocrates.

With a personal experience of clubfoot treatment over the past 50 years, Ignacio Ponseti from the University of Iowa has maintained that careful serial manipulation and casting followed by a percutaneous heel cord release yields better outcomes than the more extensive posteromedial release performed commonly in the past 2 decades.

Clubfoot occurs in about 1 in 1,000 live births and is more common in certain races or ethnic groups. For example, among South Pacific natives, the incidence of clubfoot is 7 per 1,000. Involvement is bilateral in about 50% of patients, and there is a male predominance of 2:1.

The precise pathogenesis of congenital clubfoot remains unclear. This complex disorder possibly involves genetic, neurologic, muscular, and...

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