Abstract

Background: Author published a comprehensive research article on trimorphic extreme clubfoot deformities [1], offering, all-inclusive, triple/ quadruple surgical techniques, a far reaching solution, which received tremendous Global attention. This generic name (trimorphic extreme clubfoot deformities) was given, by the author, to scores of brand names in literature, reporting 95% failures post-surgeries with contemporary techniques. “Each Clubfoot Is Different” an important discovery therein, was prominently considered, for grading of results, rather than the prevalent assessment criteria of Pirani’s or Demiglio’s etc. Additional thoughts on this were recorded in author’s invited BOOK on CLUBFOOT, published by Taylor and Francis (Informa group London U.K), ISBN: 9781138083738, released on 29th November, 2018 IOACON at Coimbatore (India). Author also performed, here, a Hat Trick, in clubfoot research, getting third best IOA original research award i.e. Diamond jubilee also; Golden and Silver awards bagged earlier in 2013 and 1988 respectively. During last about two years, as per its name, this research made significant headway with countless new features. Therefore, this has been christened as “Mother of all clubfoot discoveries/inventions”, with its deep seated roots and incredible unity in diversity in its All-inclusive, corrective, 4-in-1, surgical concept. Being so and with its unending future research potential, it needs to be free from the lockdown of Journal and BOOK, to spread awareness for the welfare of poor clubfoot community in LMICs, having more than 80% global population.

Methods: Recently conceived new features are: Firstly, formulating a comprehensive classification under numerous broad headings: Limitless variations in deformity start at birth; get modified with age, patient’s weight, weight bearing, physical activity, treatments, early/ delayed complications, radiological variations etc. Secondly, the landmark, revelation in Rediscovery of Octopus Clubfoot, DOI: 10.31031/OPROJ.2019.06.000627 and stamping its surgical correction as all-inclusive, branded, surgical concept; A Unity in Diversity. This was proved earlier by actually showcasing innumerable diverse deformities with gratifying results in author’s International Orthopaedics as well as BOOK publications. This has been further strengthened with more new cases in this article (Table 1). Thirdly, many newer surgical steps have been added in the surgical corrections of these cases in the appropriate section in this article.

Results and Conclusion: This MASTERSTROKE article, a GRASSROOTS DISCOVERY, needs to spread awareness for an impactful message, giving a far better deal to poor Clubfoot community of LMICs, at lesser cost, with longer, good looking, better functioning feet, on long term, without any bony fusion and improving the patient’s psycho-physico-socio-economics, helping indirectly their countries economy. The research in this entity is unending, each being different, therefore increasing awareness highly important. This will increase the demand for these surgeries and thereby a need for learning these comprehensive techniques through available internet channels and setting things going.

Keywords: Mother of clubfoot innovations; “Each clubfoot is different”; Extreme clubfoot deformities; Fusion 4-in-1 surgical concept; Octopus clubfoot rediscovered; Unity in diversity; Triple/ Quadruple surgical skin expansion; Cosmetic/Plastic surgery in clubfoot; Rozy feet

Abbreviations: AGMC: Arthrogryposis Multiplex Congenita; CCBs: Congenital Constriction Bands; CPC: Conjoint Posterior Capsule, DALYs: Disability Adjusted Life Years; DL: Dorsolateral; DOLAR: DOrso-Lateral Rotation; EQ: Equinus; FDP: Flexor Digitorum Longus; FHL: Flexor Hallucis Longus; GBD: Global Burden of Disease; IOA: Indian Orthopaedic Association; IOACON: IOA Conference; IT: Intertarsal; ITC: Interosseous Talo-Calcanean; OA: Osteoarthritis; PMPDLR: Posteromedial Plantar Dorsal Lateral Release; TMT: Tarsometarsal