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Operative Timing for Club Foot Deformity

- Discussion:
      - best time to do the operative procedure is debatable;
      - although some surgeons have recommended that the surgical release be done within the first few days or weeks of life, it is generally
             agreed that this is not advisable;
      - there is an abundance of fatty tissue in the foot of the very young infant, and the small bones and cartilaginous structures are sometimes 
             difficult to identify;
      - most orthopaedic surgeons delay surgical intervention until the infant is approximately four to six months old;
      - there is no evidence that children who are operated on at an earlier age have better results;
      - proponents of operating at an earlier age have suggested that realignment of the talus, the calcaneus, and the navicular results in better 
             remodeling of the articular surfaces;
      - in small feet the dissection requires meticulous attention in dealing with the immature tissues to avoid scarring and residual stiffness;
      - surgical release usually is performed somewhere between 3-9 months of age, according to the individual surgeon's preference, and a
              variety of incisions can be used

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