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Review Article: A. Siapkara and R. Duncan Congenital talipes equinovarus: A REVIEW OF CURRENT MANAGEMENT J Bone Joint Surg Br 2007; 89-B: 995-1000 [Abstract] [Full text] [PDF]

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Congenital talipes equinovarus

Mansoor A Khan, Muhammad .A. Chinoy   (18 October 2007)

Congenital talipes equinovarus 18 October 2007
Mansoor A Khan, Orthopaedic Surgeon Indus Hospital, Karachi, Pakistan, Muhammad .A. Chinoy Send letter to journal: Re: Congenital talipes equinovarus makbonedoc{at}cyber.net.pk Mansoor A Khan, et al.	Sir, We read this review article with interest. We found the article quite complete and informative regarding the management of Congenital talipes equinovarus (CTEV) as a primary presentation, as well as looking at recurrent and resistant deformities. However, in our opinion there was a major omission in that there was no mention of the late presenting neglected clubfoot and its management. This is an extremely important problem in the developing world.1 Personal experience (unpublished data) suggests that for every newborn that we see with CTEV, we will see three to four patients presenting at ages of several months to several years. As journals are often the only source of medical information in the developing world, review articles should reflect this when covering a problem as common as CTEV. We would like to draw the attention of the authors to our paper, "Treatment of severe and neglected clubfoot with a double zigzag incision: outcome of 21 feet in 15 patients followed up between 1 and 5 years" publshed in the Journal of Foot and Ankle Surgery, May/June 2006.2 This is a review of the problem of late presenting neglected CTEV as well as the only report in the English language describing the outcome of the double zigzag incision, as described by Morrisey.3 We would encourage all those faced with the difficult task of treating late presenting CTEV to review our paper. We would also encourage all authors of future review articles in JBJS to try and cover aspects of disease with the developing world in mind. This is where the bulk of disease is and where the challenge lies. M.A. Khan, MBBS, FCPS, M.A. Chinoy, MBBS, FRCS, Indus Hospital, Karachi, Pakistan. 1. Calder J, Mannion S. Orthopedics in Sri Lanka post-tsunami. J Bone Joint Surg [Br] 2005;87-B:759-61. 2. Khan MA, Chinoy MA. Treatment of severe and neglected club foot with a double zigzag incision: outcome of 21 feet in 15 patients followed up between 1 and 5 years. J Foot Ankle Surg 2006;45:177-81. 3. Morrisey TM. Surgical correction of clubfoot. In: Atlas of Pediatric Orthopedics Second ed. Lippincott Raven, 1996.