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Results of posteromedial release for the resistant clubfoot
Insights
Surgical correction of resistant clubfeet in children yielded good to acceptable radiographic and clinical outcomes. Early surgical intervention demonstrated favorable results, though cosmetic appearance was occasionally suboptimal.
Area of Science:
- Orthopedic surgery
- Pediatric orthopedics
- Pediatric reconstructive surgery
Background:
- Clubfoot is a common congenital foot deformity.
- Resistant cases require surgical intervention.
- Age at surgery may influence outcomes.
Purpose of the Study:
- To evaluate surgical outcomes for resistant clubfeet in children.
- To assess the impact of age at surgery on results.
- To correlate radiographic and clinical findings.
Main Methods:
- Retrospective review of 99 clubfeet in 69 children operated between 1973-1979.
- Patients categorized into three age groups at surgery: <12 months, 12-36 months, >36 months.
- Minimum 30-month follow-up (average 58 months) with radiographic and clinical assessments.
Main Results:
- 95 out of 99 feet (96%) showed good or acceptable radiographic results based on the talocalcaneal index.
- Clinical assessment of pain and function corroborated radiographic findings.
- Cosmetic appearance was occasionally less than optimal despite functional success.
Conclusions:
- Surgical treatment for resistant clubfeet in children provides good to acceptable radiographic and functional outcomes.
- Age at surgery did not appear to be a limiting factor for success in this series.
- The surgical approach is effective in improving pain and function, with acceptable radiographic results.
Abstract:
Sixty-nine children with 99 resistant clubfeet were operated on between 1973 and 1979 at the James Whitcomb Riley Hospital for Children (Indianapolis, IN). Three groups of children according to age at the time of surgery were identified: Group I, less than 12 months of age; Group II, between 12 and 36 months of age; and Group III, greater than 36 months of age. Minimum follow-up was 30 months, with an average follow-up for the entire series of 58 months. The radiographic results based on the talocalcaneal index revealed 95 of the 99 feet to have good or acceptable results. The clinical assessment of pain and function mirrored these good results, although, on occasion, the appearance was somewhat less than optimal.