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Classification of Club Foot

- Postural clubfoot:
    - not a true structural deformity;
    - postural, or mild, club foot is uncommon & is corrected passively w/little difficulty;

- Moderate Club Foot;
    - moderate club foot is fairly supple, a transverse crease is absent, and the heel is easily definable;
    - most common group & responds most often to gentle manipulation or realignment, followed by application of a corrective plaster cast
    - majority of these feet do not need operative treatment;

- Severe Club Foot:
    - severe club foot is less common than moderate club foot, and it almost always requires surgical correction;
    - foot is quite short, exhibits a transverse crease in the sole, and has very tight skin, and it responds poorly to realignment stretching
         before application of a cast;
    - it often is difficult to palpate calcaneus because of the underlying fatty tissue;

- Hind Foot:
    - most severe deformities in club foot occur in hind part of foot;
    - talus and calcaneus are generally deformed and in severe equinus, calcaneus is in varus angulation and medially rotated, & navicular is 
         severely displaced medially;
    - these components of the deformity are inextricably interrelated;
    - ligaments of posterior aspect of ankle & of medial & plantar aspects of foot are shortened and thickened;
    - muscles & tendons of the gastrocnemius, tibialis posterior, and toe flexors are shortened

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