Posterolateral release for idiopathic clubfoot: review of 18 patients

The authors treated and reviewed 18 patients with 26 idiopathic clubfeet by posterolateral release and elongation of the tendo Achillis at a mean age of 14.6 months (range 7-32 months). The mean follow-up of these patients was 43 months (range 6- 100 months). Function, appearance, and pain were studied. The mean ankle dorsiflexion was 20 degrees at the time of review. In all but one case, the hindfoot equinus had been well corrected. Subtalar movement was 75% of normal in six feet, and 50% of normal in 16 feet. Revision of the posterolateral release combined with anteromedial release was carried out for six patients with residual hindfoot varus and forefoot adduction at an average of 13.5 months following the initial procedure. In one patient, the deformity was overcorrected, but the results of the rest of the revision operations were otherwise good. No skin or wound problems were observed in this series. In conclusion, of 26 feet undergoing posterolateral release for severe clubfoot, 70% had a satisfactory result. Six feet required further surgery (reoperation rate of 23.1%).