Congenital clubfoot with concomitant peroneal nerve palsy in children

We investigated the prognosis and clinical importance of concomitant peroneal nerve palsy in congenital clubfoot. Six children (6 feet) with concomitant peroneal nerve dysfunction treated by various means and with no other related syndrome or neuromuscular disorder were studied. Their clinical outcomes and their parents' satisfaction with the outcome were assessed. Patients' average age at initial diagnosis was 5.1 months (range, 2 weeks to 13 months). The average length of follow-up was 67.4 months (range, 1-11 years). Nerve conduction velocity tests and electromyography were performed in six patients; serial cast correction, followed by application of an orthosis and periodic observation, was followed in two patients; and additional surgical correction was done in four patients whose deformity was not corrected by casting and an orthosis. None of the six patients recovered from peroneal nerve palsy and their parents reported a low level of satisfaction with the outcome of the treatment. It is important to detect the rare combination of peroneal nerve palsy and clubfoot, and to explain the poor prognosis to patients' parents before treatment.