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Treatment of congenital club foot with a modified Denis Browne splint
1Department of Orthopaedic Surgery, Tokyo Medical and Dental University, Japan.
Insights
A modified Denis Browne splint effectively treated congenital club feet in children, with most cases showing excellent or good function after 6 years. This non-operative approach corrected deformities, reducing the need for surgery.
Area of Science:
- Orthopedics
- Pediatric Orthopedics
- Pediatric Surgery
Background:
- Congenital clubfoot is a common birth defect requiring effective treatment.
- Traditional treatments may involve surgery, but non-operative methods are preferred when possible.
Purpose of the Study:
- To evaluate the long-term effectiveness of a modified Denis Browne splint for treating congenital club feet.
- To assess the functional and radiographic outcomes of non-operative clubfoot management.
Main Methods:
- A modified Denis Browne splint with custom-molded plastic inserts was used.
- Treatment was initiated in infants aged 4 weeks to 9 months.
- Follow-up averaged 6 years and 3 months, with radiographic and functional assessments.
Main Results:
- Sixty feet (out of 91) treated with splintage alone showed excellent or good function.
- Radiographic assessment confirmed successful correction of equinus, adduction, varus, and cavus deformities.
- Only 20 children (31 feet) required subsequent surgical intervention.
Conclusions:
- The modified Denis Browne splint is a highly effective non-operative treatment for congenital club feet.
- This method achieves excellent functional and radiographic correction, minimizing the need for surgery.
- Long-term follow-up demonstrates sustained positive outcomes in pediatric clubfoot management.
Abstract:
We treated 91 congenital club feet in 59 children using a modified Denis Browne splint, and followed them for an average of 6 years and 3 months. The modified splint has an aluminium crossbar holding a pair of plastic shoe inserts moulded into corrected positions, and its use was started in children whose ages ranged from four weeks to nine months. Operation was later required in only 31 feet in 20 children. We have reviewed the other 60 feet in 39 children treated by splintage alone. All 60 feet had excellent or good function and from radiographic assessment, equinus, adduction, varus and cavus deformities had all been well corrected. Our results show that the modified splint can give good results.