The pathologic anatomy of the congenital talipes equinovarus (CTEV) is complex and the opportunities to examine neonatal specimens are inevitably rare. (Howard and Benson, 1993). Therefore, over the last few years a large number of anatomical, radiological, CT, three dimensional (3D) computer modeling and MRI studies have been performed on this condition. Together with the surgical findings, they have contributed much to the better understanding of this complex 3D deformity. (Cahuzac et al., 1999).Many studies of CTEV have confirmed the gross changes in the shape and position of the bones of the foot and ankle. The tarsal bones are smaller than normal, and the ossification is delayed. The talus was deformed, with its neck is medially angulated. The body of the calcaneus was medially bowed and was tilted and rotated medially underneath the talus and both the talus and the calcaneus were in planter flexion. The tilting of the talus and the medial tilting and rotation of the calcaneus accounted for the varus deformity of the hindfoot. The varus and adduction deformity of the heel and midfoot caused the supination seen in CTEV. (Ippolito, 1995). The skeletal components of the forefoot were adducted a result of the medial displacement of the navicular and cuboid. Ligamentous and tendon abnormalities were also observed with increased fibrosis of the muscle tissue, which may be an important factor in causation of the CTEV. (Ippolito, 1995). The goal of treatment of CTEV is to reduce or eliminate the deformities so that the patient has a functional, pain-free, plantigrade foot, with good mobility and dose not need to wear modified shoes. (Dobbs et al., 2004). But the treatment of CTEV continues to be controversial. (Ippolitio et al., 2003). And the determination of the optimum treatment for CTEV has been hampered by the lack of follow-up studies. (Cooper and Dietz, 1955). So that, there is nearly universal agreement that the initial treatment of CTEV should be non-operative, regardless the severity of the deformity. (Dobbs et al., 2004). The non-operative treatment typically involves serial gentle manipulations followed by the application of a short or long leg cast at weekly intervals. (Kite, 1972). While this technique is the mainstay of non-operative intervention in North America, physiotherapy and continuous passive motion without immobilization have been successfully used in France. (Dobbs et al., 2004). Although all of these methods have the potential to be successful when applied correctly, most authors have reported a success rate of only 15% to 50%. (Dobbs et al., 2004). A notable exception is the Ponseti method, which involves serial manipulation, a specific technique of cast application, and a possible percutaneous Achilles tenotomy. The method has been reported to have short-term success rates approaching 90%, and the long-term results have been equally impressive. (Laaveg and Ponseti, 1980). Surgery has been advocated for the feet that do not respond to initial conservative treatment or which relapses. The age of the patient at operation is thought to be an important factor in long-term outcome. (Huang et al., 1999).Various methods of surgical treatment of CTEV have been introduced which consist of soft tissue release operations described by Turco (1971), Simons (1985) and Carroll et al. (1978). And other surgeons described tendon transfer operations to achieve dynamic muscle balance in order to maintain the correction. (Huang et al., 1999). While the bony osteotomies operations are described for resistant or residual deformities, and the appropriate procedure and combination of procedures depend on the age of the child, the severity of the deformity and the pathological processes involved. (Cummings et al., 2002). In 2004 Ippolito et al. performed CT to investigate how treatment may modify the basic skeletal pathology of CTEV. Two homogenous groups of patients treated by one of the authors or under his supervision were studied. The first group was treated by manipulation, application of toe-to-groin plaster casts and an extensive posteromedial release. The second group was treated by the Ponseti manipulation technique, application of toe-to-groin plaster casts and a limited posterior release. At follow-up the shape of the subtalar, talonavicular and calcaneocuboid joints was found to be altered in many feet in both groups. This did not appear to be influenced significantly by the type of treatment performed. Correction of the heel varus and the increased declination angle of the neck of the talus were better in the CTEV of the second group, whereas reduction of the medial subluxation of the navicular was better in the first. There was a marked increase in the external ankle torsion angl in the first group and a moderate increase of this angle in the second group, in which medial subluxation of the cuboid on the anterior apophysis of the calcaneum was always corrected. Equinus was corrected in both groups but three-dimensional CT reconstruction of the whole foot showed that cavus, supination and adduction deformities were corrected much better in the second group.Other changes have been reported by Huber et al. in 2002 after talar neck osteotomy. And by Swann et al. in 1969 after rough methods of manipulations. Skin problems such as wound dehiscence, skin necrosis, sloughing and abnormal scar fibrosis are reported by Uglow and Clarke in 2000.