CONGENITAL CLUBFOOT. CLASSIFICATION, ETIOLOGY, PATHOGENESIS, THE EVOLUTION OF TREATMENTS (LITERATURE REVIEW)

Congenital clubfoot deformity takes the 2 nd place among the malformations of the muskuloskeletal system and is observed in 4-5 ‰ of newborn. More often the deformity is bilateral, in 20 % of cases it is associated with other developmental disorders and is frequently seen in different syndromes. Clubfoot classifications are variable and are constantly improved according to the practical needs. It is generally assumed that clubfoot is a polyetiological disease. The main theories of its development are congenital (genetic), mechanical and neuromuscular. The majority of specialists consider that clubfoot formation is due to dysplastic process with the predominant foot and shin lesion. Bone, neuromuscular or vascular system hypoplasia predominate depending on the severity of the deformity. Evolution of the clubfoot treatment methods occurs in a spiral-form fashion from the conservative management to total releases and bone reconstructions, from low-invasive to excessively radical surgery. At present the spiral turn has stopped at the consisting of many stages low-invasive method of clubfoot correction developed by I. Ponseti which is considered now to be the golden standard of treatment.