Seattle Clubfoot Orthosis

GEORGE W. SIMONS, MD**Milwaukee, Wisconsin

We have used McCollum's clubfoot orthosis for night use, described in Clinical Orthopedics and Related Research, for ten years. The splint consists of a straight-last open-toe high top shoe attached to a foot plate. Posteriorly, the foot plate has a universal joint joined to a vertical bar which is secured on the upper calf by Velcro strapping. A second bar projects laterally from the anterior part of the foot plate; a leather strap connects the anterior bar to a buckle on the Velcro strap.

The splint maintains correction of hindfoot equinus and varus by tension on the leather strap which dorsiflexes and everts the foot. The shoe tends to maintain the forefoot in correct position. The orthosis is used on the foot fully corrected by conservative or operative management. The splint should be worn a minimum of two years, and should be supplemented by passive stretching exercises. The only contraindication would be the patient who has limited plantar flexion resulting from either a flat top talus or anterior ankle contracture resulting from prolonged cast immobilization.

**Foot Clinic of Children's Hospital of Wisconsin, 1700 West Wisconsin Avenue, Milwaukee, WI 53233