Fig. 5A–B.

(A) Boy with bilateral clubfoot treated at 2 weeks of age with manipulations and toe-to-groin plaster cast applications weekly until 3 months of age. The left Achilles tendon was sectioned subcutaneously to correct equinus. After the casts the patient wore Denis Browne splints on shoes full-time for 2 months and only at night until 3 years of age when they were discontinued against our advice. The clubfeet at that time were fully corrected. The patient returned at 8 years of age with relapse in both feet, worse on the left than on the right. On the right foot the anterior tibial tendon was transferred to the third cuneiform and the extensor hallucis longus was transferred to the neck of the first metatarsal. On the left foot the anterior tibial tendon was transferred to the third cuneiform following medial soft tissue release and lengthening of the posterior tibial tendon. The Achilles tendon was lengthened bilaterally. At 19 years of age the patient has no complaints and the feet are well aligned. The strength of the transferred anterior tibial is 5 + bilaterally. Subtalar motion is normal on the right and limited to 25 per cent of normal on the left. Ankle dorsiflexion is limited to 10 degrees bilaterally and plantar flexion is free to 25 degrees bilaterally. (B) Standing anteroposterior and lateral roentgenograms. The talocaneal angle is within normal limits on both sides. The naviculars are slightly wedge-shaped bilaterally and the right is medially displaced. The talonavicular joint is slightly narrower on the left than on the right. The left second metatarsal is dense and its head is flat. In the anteroposterior roentgenograms the talco-calcaneal angle is 18 degrees on the right and 20 degrees on the left.