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MINERVA ORTOPEDICA E TRAUMATOLOGICA
A Journal on Orthopedics and Traumatology
Minerva Ortopedica e Traumatologica 2005 December;56(6):511-8
The Montpellier method for the treatment of congenital talus equino-varus
Dimeglio A., Canavese F., Charles Y. P.
Unit of Pediatric Orthopedic Surgery CHU Lapeyronie, Montpellier, France
Physiotherapy of club foot is urgent and should be performed as soon as possible. At birth, only 35% of the foot is ossified: cartilagineous bones are soft and flexible, whereas the fibrous structures are very tough. The functional method (“the Montpellier method”) aims to release the retracted soft tissue around the posterior tibialis muscle and Achilles tendon and to thus restore the muscle balance of the hind foot. The deformity of the talus can be increased by inappropriate manipulations. The correction is based on the principle that the calcaneus is involved in the equinus, varus and adduction of the deformed foot. Correction must be progressive and gradual. Manipulations must be performed at least once a day; muscle stimulation and a bandage complete the manipulations. A passive motion machine must be used in the first days of life and as often as possible during the first 3 months: the machine itself is not enough to correct the deformed foot. It’s part of a strategy in which the functional method plays a key role.