Most clubfeet in otherwise normal children can be corrected with weekly manipulations followed by plaster-cast applications. If the deformity is not corrected in 5 to 7 plaster-cast changes, the treatment is most likely faulty. A foot deformity called metatarsus varus or metatarsus adductus is often confused with the clubfoot deformity. The metatarsus adductus is a mild turning in of the foot which often corrects by itself. In more severe cases it can be easily corrected with two to three plaster-cast applications.
Some doctors believe they have corrected clubfeet when they have corrected metatarsus adductus.
The manipulative treatment of clubfoot deformity is based on the inherent properties of the connective tissue, cartilage, and bone, which respond to the proper mechanical stimuli created by the gradual reduction of the deformity. The ligaments, joint capsules, and tendons are stretched under gentle manipulations. A plaster cast is applied after each weekly manipulation to retain the degree of correction and soften the ligaments. The displaced bones are thus gradually brought into the correct alignment with their joint surfaces progressively remodeled yet maintaining congruency. After two months of manipulation and casting the foot appears slightly overcorrected After a few weeks in splints however, the foot looks normal.