M.B. Dobbs, R. Nunley, and P.L. Schoenecker reply:Dr. Goyal and colleagues raised two valid points. Their first point was the
importance of having an accurate preoperative classification system with which
to document the severity of the clubfoot deformity. We agree that this would
be the ideal situation. However, the patients in this study were initially
seen and evaluated a minimum of twenty-five years ago, and no uniform
classification system was being used at that time. All of the patients were
treated with extensive soft-tissue release surgery, which gives some
indication of the severity of the initial deformity.