Depicted in art and antiquity
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Dr. Sunil Wijayasinghe takes MediScene down the corridors of time to uncover clubfoot depicted in art and antiquity and also the evolution of treatment.
He shows a picture of a clubfoot warrior in Greece galloping off to battle, contributing as a functional member of society and describes how there are records in the Neolithic Period (New Stone Age) back in 10,000 BC of adult clubfoot, while the first medical description of this deformity is found in ancient Egypt in 3,000 B.C.
Greek physician, Hippocrates, of the Oath fame is credited with the description of the first treatment of gentle and frequent serial manipulations and bandages to immobilize the foot as far back as 400 BC, though by the end of the Middle Ages and the Renaissance in the 15th, 16th and 17th centuries, clubfoot and other deformities were poorly treated and managed by barber-surgeons, charlatans and bone-setters, says Dr. Wijayasinghe.
He says: “There are not many papers reporting clinical features because the pathogenesis of clubfoot was frequently linked to superstition and often considered a bad omen.
“During the Renaissance, France’s Ambroise Pare (1510–1590), nearly 2,000 years after Hippocrates, described essentially the same technique for clubfoot treatment and used some ingenious slippers and boots to help maintain the correction. This was while Italy’s Garbriele Falloppio (1523-1562) considered the greatest anatomist of the 16th century tried out gradual correction day-by-day ‘with great force’ and applied a soft towel or bandages soaked in ointment, subsequently resorting to metal splintage and special shoes.”
Next he picks up the treatment by Germany’s Wilhelm Fabry (1560-1634) who describes a device of double-screw stretchers; England’s William Cheselden (1688-1752) who was one of the first to introduce specific bandaging techniques, having soaked the bandages in a mixture of egg white and flour, after a short manipulation; and many more; and finally Australian Denis J. W. Browne (1892-1967) who used a splint.
Then of course, came Dr. Ignacio Ponseti.