Predictive value of intraoperative clubfoot radiographs on revision rates

The predictive value of intraoperative radiographic assessment and its correlation with short term revision rates is presented for surgical correction of resistant clubfoot. Seventy-three children (115 feet) who underwent a primary procedure at one institution for idiopathic clubfoot between January 1991 and December 1994 were reviewed. A strategy using sequential release guided by intraoperative radiographs was employed in all cases. The intraoperative radiographic findings correlated with the need for early revision surgery, with residual radiographic evidence of cavus deformity associated with the greatest risk for revision. The sequential release strategy resulted in fewer overcorrections compared with historical controls of more complete subtalar release.