Which operation, and how long ago

Soft-tissue surgery adjusts tension. A tight heel cord is lengthened, a contracted capsule is released, a tendon is moved to pull from a better direction. The result heals, settles, and thereafter behaves like a foot with slightly different tissue lengths. Reviewers treat this lightly because it usually deserves to be treated lightly.

Bone surgery changes architecture. Cutting and reorienting a bone alters how force travels through the foot permanently, and it does so in ways that continue to matter decades later. That is not a reason for refusal, and it is a reason for closer reading.

Fusion is a separate category, because deliberately removing a joint’s motion is a trade, not a repair. It has its own page for that reason.

Fifteen years without treatment says something no letter can say. It demonstrates, instead of asserts, that the correction held and the foot has been functioning without intervention through everything an ordinary life throws at it. Reviewers weigh that heavily because it is the closest thing available to a test of durability.

The corollary is uncomfortable for anyone with recent surgery: you cannot compress that timeline. If an operation is two years old, no amount of documentation makes it fifteen. Occasionally the honest advice is that applying later, with more time behind the repair, produces a better outcome than applying now with a strong packet.

Most adults treated for clubfoot (club foot, or talipes equinovarus) before the 2000s have no records and only a vague family account. That is the norm, not a failure of diligence, and reconstruction gets you further than people expect: scar position indicates the approach, imaging shows what the bones look like now, era narrows the likely technique, and a parent’s memory of casts and hospital stays fills in the rest.

Write it down once, in one document, and reuse it. A clear reconstructed history with an honest note about which parts are inferred is far better received than a vague verbal account that shifts between tellings.

A clock expires. An absolute never does. A symptom test asks whether the thing actually does anything. Nearly every orthopedic criterion is one of those three, and knowing which one yours is decides whether you have a problem, a waiting game, or a documentation job. The guide works through all three with the criteria quoted.