Correcting residual deformity following clubfoot releases.
There are many possible pitfalls of clubfoot releases and it is important to recognize the problems and provide proper timely treatment. Late residual deformity following clubfoot releases include: dynamic or stiff supination and forefoot adduction deformities, intoeing gait, overcorrection, rotatory dorsal subluxation of the navicular, vascular insult to the talus with collapse, and dorsal bunion. We reviewed 134 clubfeet in 95 children who had primary clubfoot releases between 1988 and 1991. In general, the patients who underwent surgery before 6 months of age had poorer results compared with older children. Twenty-one feet (15.7%) underwent additional procedures. The most common additional procedure was split anterior tibial tendon transfer. Not all patients with residual deformities underwent additional procedures. In treating recurrent and residual deformity following a clubfoot surgery, it is most important to keep function in mind. From this series of patients treated with comprehensive clubfoot release, we have identified the most common residual deformities encountered after the initial release and effective surgical treatment when necessary.


METHODS
Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
Kuo
Ken N
KN
National Taiwan University Hospital, National Health Research Institutes, 35 Keyan Road, Zhunan, Miaoli, 35053, Taiwan, ROC. kennank@aol.com
Smith
Peter A
PA
D000367:Age Factors; D001915:Braces; D002370:Casts, Surgical; D003025:Clubfoot / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D019637:Orthopedic Procedures / Q000009:adverse effects; D004856:Postural Balance; D011859:Radiography; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012008:Recurrence; D012086:Reoperation; D012189:Retrospective Studies; D013709:Tendon Transfer; D013997:Time Factors; D016896:Treatment Outcome