CENTER FOR EXCELLENCE IN FOOT

Texas Scottish Rite Hospital for Children treats more than 100 new patients with clubfoot disorders each year and has more than 1,000 clubfoot-related clinic visits annually. In addition, the hospital treats an increasing number of complex adolescent foot disorders. Collectively, these conditions are combined to form the Center for Excellence in Foot.  

Under the direction of B. Stephens Richards, M.D., the center facilitates extensive research into clubfoot – its cause, the effectiveness of operative and nonoperative treatments, and the study of gait patterns in clubfoot patients. The two nonoperative treatment methods, the Ponseti casting method and the French Functional (physical therapy method of stretching), massaging and taping have been shown to be effective and are most successful if the treatment begins early in the newborn period. Collaboration with our bioengineers, the Movement Science Lab, Molecular Genetics, orthotists and physical therapy lead to the optimal research environment.  

Research in complex adolescent foot disorders is increasing under the direction of Anthony Riccio, M.D. In conjunction with an adult foot and ankle specialist, our orthotists and the Scottish Rite Hospital Movement Science Laboratory, efforts are underway to determine how the management of difficult foot disorders in adolescents and young adults can be optimized. Residual painful foot deformities following surgery years earlier, rigid flat feet, stiff cavovarus feet and the adult sequelea of congenital foot deformities are among the conditions being investigated.  

Current Studies

The purpose of these studies is to determine the success of nonoperative treatment of clubfoot disorders at 2 years and 5 years, determine how often surgical treatment is needed, determine the frequency of clubfoot that is nonidiopathic, measure compliance of maintenance bracewear for corrected clubfoot disorders, and determine usefulness of radiographs in clubfoot treatment.
 
Multicenter collaboration is underway to study the human genome in an effort to identify genes associated with clubfoot disorders along with variation in genes that may be involved in this deformity’s etiology. 
 
These studies examine the function and position of corrected feet at age 2 years and 5 years following nonoperative treatment. In those who need limited surgery, tendon transfers can result in better foot positioning. 
 
This prospective registry has been established to collect objective and patient-reported outcome data in adolescents and young adults being managed for a variety of complex foot and ankle deformities. This data should help shed light on how to better manage the sequelae of congenital and acquired pediatric foot problems in those nearing adulthood.