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Calcaneocuboid malalignment in clubfoot
1Princess Margaret Rose Orthopaedic Hospital, Edinburgh, United Kingdom.
Journal of Pediatric Orthopedics. Part B
|October 8, 1999
Summary
Calcaneocuboid malalignment in clubfeet does not negatively impact surgical outcomes. Revision surgery is indicated when talocalcaneal correction is uncertain, especially before navicular ossification.
Area of Science:
- Orthopedic surgery
- Pediatric orthopedics
- Foot and ankle surgery
Background:
- Clubfoot is a common congenital foot deformity requiring surgical correction.
- Calcaneocuboid malalignment is a potential radiographic finding after clubfoot surgery.
- The clinical significance of calcaneocuboid malalignment requires further elucidation.
Purpose of the Study:
- To assess the clinical significance of calcaneocuboid malalignment in surgically treated clubfeet.
- To determine the impact of calcaneocuboid malalignment on revision rates and further surgical intervention.
- To evaluate the relationship between calcaneocuboid malalignment and talocalcaneal angles.
Main Methods:
- Retrospective analysis of 179 surgically treated clubfeet with 3-14 years follow-up.
- Standardized anteroposterior radiographs were used to assess calcaneocuboid malalignment.
- Correlation of radiographic findings with revision rates and need for further soft tissue release.
Main Results:
- The overall revision rate was 15%.
- Calcaneocuboid malalignment did not adversely affect the prognosis of well-corrected feet.
- Further soft tissue release was associated with talocalcaneal and calcaneocuboid angles, particularly when talocalcaneal correction was uncertain or the navicular was unossified.
Conclusions:
- Calcaneocuboid malalignment does not compromise the good prognosis of surgically treated clubfeet.
- It does not alter the surgical approach for clearly uncorrected feet.
- Surgical release of the calcaneocuboid joint is generally unnecessary if medial and subtalar dissections are complete.