Fig. 4A–B.

(A) Manipulation to correct the right clubfoot of a 6-week-old baby boy. Outward pressure is exerted on the forefoot and counter pressure on the lateral aspect of the head of the talus. The forefoot is never everted; rather, it is displaced laterally as a unit with the midfoot. Heel inversion will correct when the anterior aspect of the os calcis, together with the cuboid and scaphoid, are shifted and turned laterally in relation with the talus. (B) Antero-posterior and lateral views of the toe-to-groin plaster casts used to maintain the corrections obtained by manipulating the left foot of the baby in (A). The plaster casts were changed weekly except for the last one which was left on for 3 weeks. Observe that the forefoot was never everted. No anesthesia was used except to section the heelcords before the application of the fifth plaster cast. The right foot was treated similarly. Well fitting, high-topped shoes attached in 75 degree outward rotation on a 9- inch long steel bar then worn full-time for 3 months, and at night for 6 years.