title: Treatment of relapsed idiopathic clubfoot by complete subtalar release combined with the Ilizarov method.
abstract: This study presents the clinical and radiographic outcomes of 6 feet (4 patients) with relapsed idiopathic clubfoot that were treated with a combination of subtalar release and the Ilizarov method. The mean patient age at the time of the surgery was 7.4 years (range, 4.5-10.5 years), and the mean follow-up was 5.1 years (range, 2.0-7.3 years). All cases achieved a plantigrade foot, better walking ability, and parental satisfaction with the result. Ankle joint range of motion increased from a mean of 17 degrees (range, 10-30 degrees) preoperatively to 45 degrees (range, 35-65 degrees) at final follow-up. The talocalcaneal angle improved from a mean of 26 degrees (range, 15-34 degrees) preoperatively to 55 degrees (range, 47-65 degrees) at follow-up. The mean tibiocalcaneal angle improved from 95 degrees (range, 87-115 degrees) preoperatively to 80 degrees (77-83 degrees) at follow-up, whereas the talometatarsal angle improved from a preoperative mean of -19 degrees (range, -35 to -10 degrees) to 3.5 degrees (range, -5 to 7 degrees) at follow-up. Recurrence was observed in only 1 foot with forefoot adductus, caused by a pin tract infection and early fixator removal. These cases suggest the Ilizarov method combined with subtalar release are beneficial for the treatment of relapsed idiopathic clubfoot.
authors.affiliation: Department of Orthopaedic Surgery, Osaka National Hospital, Osaka, Japan.
authors.forename: Takanobu
authors.initials: T
authors.lastname: Nakase
authors.forename: Natsuo
authors.initials: N
authors.lastname: Yasui
authors.forename: Kenji
authors.initials: K
authors.lastname: Ohzono
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Shimizu
authors.forename: Hideki
authors.initials: H
authors.lastname: Yoshikawa
mesh_terms: D002648:Child; D002675:Child, Preschool; D003025:Clubfoot / Q000601:surgery*; D005260:Female; D006801:Humans; D018889:Ilizarov Technique; D008023:Ligaments, Articular / Q000601:surgery*; D008297:Male; D012008:Recurrence; D013380:Subtalar Joint