Frühfunktionelle Behandlung des angeborenen Klumpfußes

The concept of conservative clubfoot treatment beginning in the neonatal period has changed considerably in the last 2 decades. The rate of clubfeet requiring surgery (20%) and the extent of surgical interventions have dropped significantly. The early functional Montpellier method has proved to be highly effective for all degrees of deformity. It is used for patients from birth until the age of 1 year. The treatment during the first 3 months of life is decisive and consists of daily physical therapy, use of a continuous passive motion machine, and taping. This method represents an efficient alternative to the popular treatment of serial casting. Nevertheless, conservative clubfoot treatment reaches its limits as the degree of deformity increases and it should be complemented by a selective minimally invasive surgical concept. The technique is described systematically and its current value is discussed.