- 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