Modified posteromedial approach for the treatment of severe clubfoot deformity.
OBJECTIVE
The rhomboid flap method (RFM) is a new technique for primary skin closure utilizing a modified posteromedial approach to cover skin and soft tissue defect, which is the result of full correction of the severe club foot deformity.


METHODS
Al-Razi Orthopedic Hospital, Kuwait.


METHODS
The vertical incision of the posteromedial approach declines laterally at approximately 30 degrees from midline, which widens the rhomboid flap thus, preserving blood supply to the flap and preventing scar adhesions to the Achilles tendon. After full correction, the stretched rhomboid flap covers the wound.


RESULTS
The RFM was used in 51 patients aged between six months and 8.5 years. The follow-up was between 11 and 48 months. The RFM was used in 62 cases: 59 primary surgeries and three revisions of previous surgeries. Sufficient skin cover was achieved in all cases. In 59, healing was by primary intention and in three necroses smaller than one square centimeter developed.


CONCLUSIONS
The RFM proved to be a beneficial method in the treatment of severe clubfoot in the concerned age group.
Rejholec
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Al Razi Orthopaedic Hospital, P.O. Box 4235, 13043 Safat, Kuwait. rejholec@hotmail.com
D002648:Child; D002675:Child, Preschool; D003025:Clubfoot / Q000601:surgery*; D005260:Female; D005528:Foot / Q000601:surgery; D006801:Humans; D007223:Infant; D008297:Male; D013524:Surgical Flaps