The anatomy of uncorrected club feet. A study of rotation deformity.

There is some uncertainty about rotational deformity of the lower leg in club feet. Many standard textbooks and some monographs describe medial tibial torsion as occurring constantly or often (McMurray 1943, Turek 1959, Campbell 1963, Kite 1964, Le Noir 1966). Mercer and Duthie (1964) mentioned medial torsion but considered it rare. Ober (1920) and Ferguson (1957) noted that the fibular malleolus is often displaced backwards in spite of the alleged medial torsion, and Wynne-Davies (1964) asserted that the hindfoot is laterally rotated on the tibia. In this paper we will challenge the more generally supported belief that the tibia is medially rotated and propose that in uncorrected club feet the hindfoot and ankle mortise are laterally rotated on a tibia which has no rotational deformity. We will discuss the development and the clinical implications of this.