Outcomes of Growth Modulation for Residual Clubfoot Deformities

ObjectiveTo evaluate the radiographic outcomes, clinical effectiveness, and safety of lateral calcaneocuboid guided growth using a tension-band plate (8-plate) for the correction of residual forefoot adduction in children with idiopathic clubfoot.MethodsWe evaluated children presenting with residual forefoot adduction following previous clubfoot treatment. All patients underwent lateral calcaneocuboid-guided growth using an 8-plate. Radiographic assessment included preoperative and postoperative measurements of the talo-first metatarsal angle (T1MA), calcaneo-fifth metatarsal angle (C5MA), and the medial-to-lateral (M/L) column length ratio.ResultsFifteen feet (median age: 5 years) were analyzed. The M/L ratio showed a statistically significant improvement across the entire cohort (P < .05). While T1MA and C5MA demonstrated numerical improvement, statistical significance was primarily reached in simple deformities. Notably, a strong positive correlation was found between increasing age and improvement in the M/L ratio. Younger patients experienced a higher incidence of screw loosening and lower correction rates, likely due to softer bone density, whereas older children showed superior stability and more predictable outcomes. No major adverse events or permanent growth arrests were reported.ConclusionLateral calcaneocuboid guided growth is a safe, minimally invasive technique for managing residual forefoot adduction. However, clinical success is highly dependent on hardware stability.Levels of Evidence:Level IV: Case Series.