History of club-foot treatment; part II: tenotomy in the nineteenth century

Clubfoot is one of the most common congenital orthopaedic anomalies and was described by Hippocrates in the year 400 BC. From manipulation in antiquity to splint and plaster in the Renaissance the treatment had improved before tenotomy. Tenotomy was tested during the 19th century and will be explained in this manuscript; the introduction of subcutaneous tenotomy of the Achilles tendon had focused the attention of surgeons on the surgical treatment of clubfeet. While this operation was very successful in the correction of equinus deformities due to poliomyelitis, cerebral palsy, and old injuries, it was not a panacea for the patient with the congenital clubfoot. To be successful, the forefoot adduction and inversion had to be corrected completely before correction of the equinus deformity could benefit the patient. For this reason operations were extended to include tenotomies of other tendons, particularly the anterior tibial tendon and incisions in the capsules of the talar joints.