A preliminary report of the use of botulinum toxin type A in infants with clubfoot: Four case studies

This report describes the use of botulinum toxin type A (BTX-A) in four inf ants with very severe clubfoot deformity. The gastrocnemius and posterior t ibial muscles were injected with BTX-A after the patients reached a treatme nt plateau in physical therapy. Significant improvement in foot dorsiflexio n and foot flexibility was seen in two patients, and surgery was not requir ed. Surgical intervention was necessary in the remaining two patients, both of whom were ultimately diagnosed with a demyelinating neuropathy. The use of botulinum toxin as an adjunct to conservative care in infants with club foot is discussed.