Posteroplantar release for congenital clubfoot in children younger than 1 year.
ABSTRACT One hundred thirty-three resistant congenital clubfeet in 93 patients between 3 and 10 months of age were operated on using a standardized posteroplantar release. Clinical and radiographic assessments were done with a mean followup of 7 years 4 months (range, 3-12 years). Using the McKay score, 79.7% of the surgically treated clubfeet were classified as having a good or excellent result. Three patients had relapse of their clubfoot that required additional surgery. Seventeen feet in 15 patients had residual forefoot adduction at the time of followup. The radiographs showed that the early posteroplantar release led to sufficient hindfoot correction in all but the three patients who had relapse of the clubfoot. With this standardized surgical treatment, satisfactory results can be achieved in most patients younger than 1 year with congenital clubfoot. However, in patients with persistent talonavicular subluxation after conservative treatment, an additional talonavicular release combined with the posteroplantar release is recommended.
Article: [The effect of abductor hallucis tendon release on residual adductus deformity in the surgical treatment of congenital clubfoot].[show abstract] [hide abstract]
ABSTRACT: We evaluated the effect of abductor hallucis (AH) tendon release on residual adductus deformity in the surgical treatment of congenital clubfoot. The study included 35 patients with congenital clubfoot. Thirteen patients (group 1, 21 feet) underwent classical complete subtalar release, while 22 patients (group 2, 31 feet) underwent the same treatment combined with AH muscle release by stripping it plantarward and transecting it distally. The mean age was 19.4 months (range 13 to 39 months) in group 1, and 13.5 months (range 11 to 25 months) in group 2. The mean follow-up period was 55.5 months (range 36 to 77 months) in group 1, and 24.7 months (range 10 to 37 months) in group 2. Radiographic assessments were made on preoperative, early postoperative, and final radiographs for the anteroposterior talo-first metatarsal angle and calcaneocuboid relationship, and for the anteroposterior naviculometatarsal angle and talonavicular relationship on final radiographs. Both groups showed significant improvement in the anteroposterior talo-first metatarsal angle in the early postoperative period (p<0.001); however, early and late postoperative talo-first metatarsal angle did not differ significantly both within groups and between groups (p>0.05). The anteroposterior naviculometatarsal angle was 95.3 degrees in group 1, and 96.7 degrees in group 2. The anteroposterior naviculometatarsal angle and talonavicular subluxation were similar in the two groups (p>0.05). The early and late postoperative calcaneocuboid relationship showed significant improvement in both groups, without a significant difference between the groups (p>0.05). It seems that release of the AH muscle does not affect the incidence of postsurgical residual adduction deformity in the surgical treatment of congenital clubfoot.acta orthopaedica et traumatologica turcica 01/2009; 43(6):491-6. · 0.34 Impact Factor