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Idiopathic clubfoot: ten year follow-up after a soft tissue release procedure
Noppachart Limpaphayom1, Stephen J Kerr, Pairatch Prasongchin
1Department of Orthopedics, Faculty of Medicine, Chulalongkorn University, Rama 4 road, Pathumwan, Bangkok, Thailand, 10330, Noppachart.L@chula.ac.th.
Purpose:
Our objective is to report longitudinal outcomes of selective surgical soft tissue release for idiopathic clubfoot (ICF).
Methods:
Thirty-six ICF patients who had surgery at the average age of 11 (range nine to 17) months and 12 age-matched normal feet were evaluated yearly until subjects had the average age of 11 (range seven to 19) years using eight radiographic parameters. The Ponseti and Dimeglio scores were rated. Serial ankle and subtalar motions and talocalcaneal (TC) index changes over time were analyzed using mixed effects random-intercept longitudinal models.
Results:
At the last follow-up, ankle and subtalar motions were more restricted in the ICF but no significant changes in motion were observed over follow-up, except for small but significant decreases in the TC index in both ICF and control feet. The average measurement in ICF group versus control revealed significantly lower angles in the five assessed parameters. The mean Ponseti score was 88 (range 40-97) and ICF showed an improvement of the Dimeglio score. A positive correlation between the Ponseti score and the subtalar motion was noted, whereas talar flattening had a negative influence on the ankle motion.
Conclusions:
Soft tissue release surgery limited to only pathologies encountered during the procedure maintains motions of ankle and subtalar joints in ICF.
