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[Early results of complete subtalar release in congenital clubfoot deformity]
Lokman Karakurt1, Erhan Yilmaz, Murat Inci
1Frat Universitesi Tip Fakültesi Ortopedi ve Travmatoloji Anabilim Dali, Elaziğ. lkarakurt@hotmail.com
Insights
Complete subtalar release effectively addresses congenital clubfoot deformity. While generally successful, surgical experience is key to improving outcomes and minimizing complications like undercorrection.
Area of Science:
- Orthopedic surgery
- Pediatric orthopedics
- Congenital deformities
Background:
- Congenital clubfoot is a common birth defect requiring surgical correction.
- Complete subtalar release is a surgical technique aimed at addressing all components of clubfoot deformity.
Purpose of the Study:
- To evaluate the radiological and clinical outcomes of complete subtalar release for congenital clubfoot.
- To analyze complications and identify factors influencing surgical success.
Main Methods:
- A cohort of 20 patients (30 feet) underwent complete subtalar release using the Cincinnati incision.
- Outcomes were assessed using Simon's clinical and radiological criteria, with a mean follow-up of 24.6 months.
Main Results:
- Satisfactory clinical results were achieved in 80% of feet, while radiological success was observed in 63%.
- Undercorrection was noted in 43.3% of cases. Complications included skin necrosis and infections, with two cases of talar and navicular hypoplasia.
Conclusions:
- Complete subtalar release can correct clubfoot deformity in one surgical session.
- Surgical experience significantly impacts the success rate and complication profile of this procedure.
Objectives:
We evaluated the radiological and clinical results of complete subtalar release in patients with congenital clubfoot deformity.
Methods:
We performed complete subtalar release in 30 feet of 20 patients (14 boys, 6 girls; mean age 8 months; range 3.5 to 18.5 months). We employed the Cincinnati incision in all cases. The results were evaluated according to the Simon's clinical and radiological criteria. Tarsal bone problems were analyzed separately. The mean follow-up period was 24.6 months (range 12 to 41 months).
Results:
Clinical results were satisfactory in 24 feet (80%) and unsatisfactory in six feet (20%). Radiologically, satisfactory and unsatisfactory results were encountered in 19 feet (63%) and 11 feet (37%), respectively. Undercorrection occurred in 13 feet (43.3%) and overcorrection in one foot (1.4%). Revision surgery which was recommended for five undercorrected feet (16.6%) with unsatisfactory clinical and radiological results could be performed in four feet (13.3%). Deep skin necrosis that occurred in two feet (one with Achilles tendon necrosis) was treated surgically. Superficial skin necrosis developed in five feet and soft tissue infection in one feet, all of which responded well to conservative treatment. Other complications included talar head hypoplasia and navicular hypoplasia in two feet, respectively.
Conclusion:
Complete subtalar release allows to correct all components of clubfoot deformity in a single session. The results may appreciably be improved with enhanced surgical experience.
