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Recurrent clubfoot.

P Raab1, R Krauspe1

  • 1Orthopädische Universitätsklinik, König-Ludwig-Haus, Würzburg, Germany.

Der Orthopade
|March 2, 2017
PubMed
Summary
This summary is machine-generated.

Recurrent clubfoot in children under 10 often results from incomplete initial correction. Treatment varies by age, with repeated soft tissue release for younger children and osteotomies or arthrodesis for older ones.

Keywords:
Key words Clubfoot • Recurrent clubfoot • Relapsed clubfoot • Residual clubfoot

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Area of Science:

  • Orthopedic Surgery
  • Pediatric Orthopedics
  • Pediatric Deformity Correction

Background:

  • Approximately 25% of surgically treated clubfeet develop recurrence or residual deformity.
  • Failure of concentric reduction during initial surgery is a primary cause.
  • Persistent forefoot adduction and supination are common residual deformities.

Purpose of the Study:

  • To present surgical treatment strategies for recurrent and residual clubfeet in children under 10 years old.
  • To delineate age-specific surgical interventions for optimal outcomes.

Main Methods:

  • Retrospective review of 94 cases of recurrent/residual clubfoot in patients under 10 years.
  • Analysis of surgical techniques applied across different age groups.
  • Evaluation of soft tissue release, osteotomies, tibialis transfer, Ilizarov correction, and triple arthrodesis.

Main Results:

  • Repeated soft tissue release is effective up to 8-10 years of age.
  • For children aged 2-8 years, combined repeated release, cuboid osteotomy, and tibialis transfer are recommended.
  • For children over 8-10 years, mid-tarsal osteotomies, Ilizarov external fixation, or triple arthrodesis are considered.

Conclusions:

  • Age-appropriate surgical management is crucial for addressing recurrent and residual clubfoot deformities.
  • A stepwise approach, from soft tissue procedures to more extensive bony procedures, guides treatment decisions.
  • Tailoring surgical interventions based on patient age and deformity severity improves outcomes in pediatric clubfoot management.