Surgical correction of resistant talipes equinovarus: observations and analysis - preliminary report

The preliminary results of a comprehensive talipes equinovarus release on 16 patients with 20 idiopathic clubfoot deformities were analyzed with an 18-month follow-up. Our conclusions were that each component of the clubfoot can be managed in a single stage operative procedure without any significant risk to the patient; bilateral surgery could be done at the same sitting; and dorsiflexion was difficult to achieve because of the anatomical deformity of the talus and resistant anterior capsule. Fixation after comprehensive release with Kirschner wires is important in maintaining the reduction, and no patient had a return of the deformity after satisfactory correction at the time of surgery. The complications were excessive hindfoot valgus, loss of the longitudinal arch by excessive midfoot release and casts, and forefoot valgus from complete transfer of the anterior tibial.