[Extensive subtalar release in the treatment of congenital pes equinovarus]

The results of the surgical treatment by the method of extensive subtalar release after McKay is observed on the group of 35 feet operated on in 23 patients. In 17 feet it was the case of the recurrence after the operation, 18 feet were operated on primarily either after the conservative therapy or after no preceding therapy. Surgical technique is described in which major stress is put on the considerate approach and perfect correction of all abnormalities within one operation. A three-grade evaluation was used for the assessment of the results: good, fair, poor. Good results were achieved in 60 per cent of operated feet, 23 percent were evaluated as fair and 17 per cent as poor results. In the group of patients operated on beforehand the number of poor results is higher than in the group of patients operated on for the first time. As a supplementary procedure enucleation of os cuboideum is applied either during the basic operation or in the following period, in the second phase metatarsal osteotomy and transposition of the tendon of m. tibialis ant. into the base of Vth metatarsal are performed. This method of surgical treatment provides very satisfactory results. With the adequate performance of surgical treatment the number of complications is minimal. This type of operation is indicated for children between 1 and 4 years of age, exceptionally it can be performed also in older patients (the oldest boy in the group was 6 years old).