Clubfoot associated with preaxial polydactyly

Area of Science:

• Orthopedics
• Pediatric Surgery
• Developmental Biology

Background:

• Congenital clubfoot is a common birth defect affecting foot and ankle alignment.
• Preaxial polydactyly, an extra digit on the thumb or big toe side, can coexist with clubfoot.
• Treatment of complex clubfoot deformities, especially those with associated anomalies, presents unique challenges.

Observation:

• Three children with bilateral congenital clubfoot were evaluated.
• Four of the six clubfeet exhibited preaxial polydactyly.
• Five clubfeet were managed non-surgically with serial casting and percutaneous Achilles tenotomy.

Findings:

• A plantigrade foot, essential for normal weight-bearing, was achieved in most cases, including those with polydactyly.
• Casting techniques were adapted to accommodate the polydactyly.
• One complex case involving tibial hemimelia and tarsal polydactyly required extensive surgery, including ray resection and posterior release, resulting in a functional weight-bearing foot.

Implications:

• Non-surgical management, including serial casting and tenotomy, is effective for many congenital clubfeet, even with polydactyly.
• Surgical intervention may be necessary for complex deformities but can yield good functional outcomes.
• Further research into long-term outcomes and management of residual hindfoot issues is warranted.