The four quadrant approach to clubfoot surgery

In the last 20 years, the approach to clubfoot surgery has changed. When surgery is performed, a comprehensive posterior, medial, and lateral release is indicated. The concept of derotation of the os calcis has proved beneficial in resolving the residual pigeon-toed gait. This constitutes the fourth quadrant of correction in clubfoot surgery. The ultimate goal is to achieve a supple functioning, plantargrade foot in one sitting.