title: Gastrocsoleus fascial release for correction of equinus deformity in residual or relapsed clubfoot.
abstract: BACKGROUND
  Regardless of the mode of treatment, clubfoot has a strong tendency to relapse, especially hindfoot equinus. Because contraction or shortening of the Achilles tendon causes an equinus deformity of the ankle, release of this tendon is required to correct equinus deformity in patients with residual or relapsed clubfoot. This study assessed the effectiveness of the Vulpius technique in correcting equinus deformity in patients with residual or relapsed clubfoot.
  
  
  METHODS
  Of the 80 idiopathic clubfeet treated conservatively using the Ponseti protocol, between March 2000 and July 2008, 32 were found to have residual or relapsed equinus deformity, with 22 feet in 17 patients undergoing Vulpius-type Achilles tendon lengthening. Mean age at the time of surgery was 29 (range, 6 to 52) months, and mean follow-up was 48 (range, 24 to 78) months. Clinical evaluation included the dorsiflexion angle of the ankle and radiographic evaluation included the talocalcaneal and tibiocalcaneal angles on dorsiflexion lateral views.
  
  
  RESULTS
  All 22 feet showed satisfactory results at last follow-up, with significant improvements in mean ankle dorsiflexion angle, mean tibiocalcaneal angle, and mean lateral talocalcaneal angle (p < .05 each).
  
  
  CONCLUSIONS
  The Vulpius procedure is an effective surgical procedure for correcting equinus deformity in residual and relapsed clubfeet.
authors.affiliation: Department of Orthopaedics Surgery, Asan Medical Center University of Ulsan College of Medicine, Seoul, Republic of Korea. sspark@amc.seoul.kr
authors.forename: Soo-Sung
authors.initials: SS
authors.lastname: Park
authors.forename: Ho Seong
authors.initials: HS
authors.lastname: Lee
authors.forename: Sang-Ho
authors.initials: SH
authors.lastname: Han
authors.forename: Jin-Woong
authors.initials: JW
authors.lastname: Park
authors.forename: Maria Josephine B
authors.initials: MJ
authors.lastname: de Peralta
mesh_terms: D000125:Achilles Tendon / Q000601:surgery; D001915:Braces; D002370:Casts, Surgical; D002675:Child, Preschool; D003025:Clubfoot / Q000000981:diagnostic imaging / Q000601:surgery*; D004863:Equinus Deformity / Q000000981:diagnostic imaging / Q000601:surgery*; D000071938:Fasciotomy; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D018482:Muscle, Skeletal / Q000601:surgery; D011859:Radiography; D012008:Recurrence; D012189:Retrospective Studies; D013165:Splints; D013710:Tendons / Q000601:surgery; D058971:Tenotomy