October 23, 1973
re: MASTER DEREK FEATHERSTONE
Dear Dr. E.:
This boy now 2 years 3 months old has been followed by me since he was 8 days of age with a left club foot deformity. He was referred to me By Dr. B. who I believe was covering you for the delivery of this baby.
He has gone through a long period of cast correction of this club foot deformity in the first 9 or 10 months followed by a Denis Browne splint and out-flare last shoes on the left and more recently in the last year straight last boots with an outer heel and sole wedge on the left.
The child is still tight in his Achilles tendon and still tends to invert the heel and adduct the forefoot. He can dorsiflex 5 to 10 degrees above the neutral position and it has been borderline as to wheter or not he will need operative correction at a later stage. With his dorsiflexion above neutral we felt that we could wait on him and see whether or not spontaneous correction with further weight bearing will carry out. There is a procedure for a relapsed or residual club foot but this is best deferred until about the age of 3 1/2 or 4 and if he still has significant deformity by that age he may require this prodcedure to be carried out. In the meantime he is continuing on stretching exercises and the use of straight last boots with an 1/8 inch outer heel and sole wedge on the left.