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Correcting Residual Deformity Following Clubfoot Releases

Authors
  • Kuo, Ken N.1
  • Smith, Peter A.2
  • 1 National Health Research Institutes, National Taiwan University Hospital, 35 Keyan Road, Zhunan, Miaoli, Taiwan, 35053, ROC , Taiwan (Taiwan)
  • 2 Rush University Medical Center, Shriners Hospital for Children, Chicago, IL, USA , Chicago (United States)
Type
Published Article
Journal
Clinical Orthopaedics and Related Research
Publisher
Ovid Technologies (Wolters Kluwer) - Lippincott Williams & Wilkins
Publication Date
Dec 17, 2008
Volume
467
Issue
5
Pages
1326–1333
Identifiers
DOI: 10.1007/s11999-008-0664-y
Source
Springer Nature
Keywords
License
Yellow

Abstract

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. Level of Evidence: Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

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