Abstract
Purpose: To evaluate 2 surgical prosedures in treatment of congenital clubfeet in children younger than 24 months. Materials and methods: Data were analyzed on 319 patients (448 feet) from July 1990 to December 2005. Clinical and classification for all patients according to Dimeglio. Operated patients were devided into two group: Group1, selective soft tissue release; and Group 2, selective soft tissue release combined with cuboid decancelation. Surgical result were classified according to McKay’s system. Results: There were 103 females (32.3%) and 216 males (67.7%) in this study. There were 192 patients (268 feet) in group 1, 127 patients (180 feet) in group 2. Bilateral involvement was found in 129 patients (40.4%), only the left foot affected in 65 patients (20.4%), and only the right in 125 patients (39.2%). According to the classification of Dimeglio Grade II was seen in 32.4%, Grade III in 53,1%, and Grade IV in 14.5%. Postoperatively, in group 1, we got excellent result in 29.1%, good result in 49.2%, fair result in 18.3%, and poor result in 3.4%. In group 2, we attained excellent result in 50.6%, good result in 42.2%, fair result in 6.1% and poor result in 1.1%. The good to excellent result in group 2 was significantly higher in group 1 with p = 0.000042. There was no failure in both groups. Residual adduction of forefoot in frontal plane was seen in 78.0% of group 1, and 10.6% of group 2, which was also statistically significant with p ~ 0. Conclusion: Generally speaking, the procedure of selective soft tissue releases combined with cuboid decancelation showed an outstanding result with good to excellent result of 92.8%. Surgical procedure is simple, safe, and applicable for all patients with clubfeet’s deformyties.
Highlights
Idiopathic congenital talipes equinovarus is a common complex deformity that occurs in approximately one or two per 1000 newborns [1]
Operated patients were divided into two groups: group 1, selective soft tissue release; and group 2, selective soft tissue release combined with cuboid decancellation
A retrospective study was undertaken on 356 patients (496 feet) with congenital club foot diagnosed from July 1990 to December 2005 by compatible symptoms and signs and confirmed by imaging studies
Summary
Idiopathic congenital talipes equinovarus (clubfoot) is a common complex deformity that occurs in approximately one or two per 1000 newborns [1]. The entire population of New Zealand is 4 million people. 750,000 people claimed Polynesian ethnic background in the 2001 census. With an estimated incidence of 6.8 clubfeet per 1000 in Polynesian populations [2], compared with one per 1000 in white European populations, pediatric orthopaedic surgeons in New Zealand treat a large number of clubfeet [3,4]. Treatment of clubfoot has been controversial because initial correction of the deformity can be attained with both primarily nonsurgical and surgical methods [5]. The long-term goal of treatment is a functional, pain-free, plantigrade foot with good mobility, without calluses, and without the need for shoe-wear modification [6,7]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
