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The Oxford club-foot programme

S B Tibrewal1, M K Benson, C Howard

  • 1Nuffield Orthopaedic Centre, Oxford, England.

The Journal of Bone and Joint Surgery. British Volume
|July 1, 1992
PubMed

Insights

This study compared two clubfoot operations in children. Calcaneal tendon lengthening showed satisfactory results, while subtalar realignment had a high re-operation rate due to correction issues.

Area of Science:

  • Orthopedic Surgery
  • Pediatric Orthopedics
  • Foot and Ankle Surgery

Background:

  • Clubfoot is a common congenital foot deformity requiring early intervention.
  • Treatment strategies aim for functional correction and long-term stability.
  • Operative interventions are often necessary when conservative methods fail.

Purpose of the Study:

  • To compare the outcomes of calcaneal tendon lengthening versus subtalar realignment for treating clubfoot.
  • To evaluate the long-term efficacy and complication rates of two surgical approaches in pediatric clubfoot patients.

Main Methods:

  • Prospective review of 63 club feet in 44 patients treated with strapping and subsequent surgery.
  • Surgical options at six weeks included simple calcaneal tendon lengthening or subtalar realignment.
  • Surgical decision based on the talocalcaneal angle measured radiographically at four weeks.
  • Follow-up for a mean of 8.7 years.

Main Results:

  • Calcaneal tendon lengthening yielded overall satisfactory results.
  • Subtalar realignment demonstrated a high re-operation rate of 39%.
  • High re-operation rate for subtalar realignment was attributed to overcorrection or undercorrection of the deformity.

Conclusions:

  • Calcaneal tendon lengthening is a reliable surgical option for clubfoot treatment.
  • Subtalar realignment may lead to suboptimal outcomes due to challenges in achieving accurate correction.
  • Further research into refining subtalar realignment techniques or exploring alternative surgical methods is warranted.

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