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Complete soft-tissue clubfoot release with and without internal fixation
D Atar1, W B Lehman, A D Grant
1Orthopedic Department, Ben-Gurion University Hospital, Beer-Sheva, Israel.
Orthopaedic Review
|September 1, 1993
Summary
Internal fixation is not necessary for clubfoot surgery. A study found no significant difference in outcomes between patients with and without Kirschner wire fixation, suggesting it can be avoided in uncomplicated cases.
Area of Science:
- Orthopedic surgery
- Pediatric orthopedics
- Pediatric deformity correction
Background:
- Clubfoot is a common congenital foot deformity.
- Soft-tissue release is a standard surgical procedure for clubfoot correction.
- The role of internal fixation in maintaining correction post-surgery is debated.
Purpose of the Study:
- To compare the functional outcomes of clubfoot patients treated with and without internal fixation (Kirschner wires).
- To determine if internal fixation offers a significant advantage in maintaining clubfoot correction after soft-tissue release.
Main Methods:
- A comparative study of two groups of patients undergoing soft-tissue release for clubfoot.
- Group I: Internal fixation with two Kirschner wires for 6 weeks.
- Group II: No internal fixation. All procedures performed by a single surgeon.
Main Results:
- No statistically significant difference in functional outcomes between the two groups (P = .08, Mann-Whitney Test).
- The study suggests internal fixation does not improve results in uncomplicated clubfoot cases.
Conclusions:
- Internal fixation with Kirschner wires can be avoided in uncomplicated clubfoot cases.
- Recommendations include early cast removal and frequent manipulations to prevent joint stiffness and reduce recurrence.
- Avoiding internal fixation minimizes associated complications.