We reviewed the results of a selective à la carte soft-tissue release operation for recurrent or residual deformity after initial conservative treatment for idiopathic clubfoot by the Ponseti method. Recurrent or residual deformity occurred in 13 (19 feet) of 33 patients (48 feet; 40%). The mean age at surgery was 2.3 years (1.3 to 4) and the mean follow-up was 3.6 years (2 to 5.3). The mean Pirani score had improved from 2.8 to 1.1 points, and the clinical and radiological results were satisfactory in all patients. However, six of the 13 patients (9 of 19 feet) had required further surgery in the form of tibial derotation osteotomy, split anterior tibialis tendon transfer, split posterior tibialis transfer or a combination of these for recurrent deformity. We concluded that selective soft-tissue release can provide satisfactory early results after failure of initial treatment of clubfoot by the Ponseti method, but long-term follow-up to skeletal maturity will be necessary.

Alloy-718 and Udimet alloy 720 are gamma prime strengthened superalloys with excellent mechanical and thermal properties at elevated temperatures, as well as at cryogenic temperatures. The nickel-based alloys were improved to be resistant to creep and become stronger by changing the heat-treatment conditions. The measurement of the specific heat capacity of a nickelbased alloy is a very useful tool to investigate the effect of heat treatment. The specific heat capacity of nickel-based alloys Alloy-718 and Udimet alloy 720 were measured using a differential scanning calorimeter in the temperature range of 100 -1000 K. The specific heat capacity of the nickel-based alloys increases monotonically with temperature; however, above 800 K, it is strongly dependent on the heat treatment conditions and it is thought to be influenced by the precipitation phase (γ , γ ). Optical and scanning electron microscopies are used to investigate the microstructure of the phases. The microstructures of the precipitates are examined.