We treated 4 cases of rigid club feet associated with Kniest dysplasia. Cases 1 and 2 had severe bilateral deformities, and talectomy with tendoachilles lengthening and triple arthrodesis were performed. After operation they gained self-ambulation, but forefoot adduction and hindfoot equinovarus remained in both cases. Case 3 had moderate unilateral foot deformity which was surgically treated by lateral wedge osteotomy and tendoachilles lengthening. Ambulatory status improved, although slight forefoot adductus remained. Case 4 had bilateral mild feet deformities which were treated with corrective casts, but this was not effective. When the club foot deformity is severe in Kniest dysplasia, bone surgery is necessary to gain ambulation in infancy. However complete correction is very difficult with only a single operation, and our first two cases will need repeat surgery to correct their residual deformity.
