Neonatal treatment of congenital idiopathic clubfoot: a two stages method of surgical treatment

ABSTRACT

Two basic stages of surgical management for idiopathic talipes equinovarus [TEV] were described. In the first stage, all components of the club foot deformity was early corrected in 50 feet. The deformed feet were corrected initially by manipulation and serial plaster casts at weekly intervals for six weeks. The operative release of tight soft tissue was indicated when the deformity was not completely resolved by this specified period of time of conservative treatment. In the second stage, the corrected foot was maintained surgically by shortening of the peronei and anterior translocation of the peroneus brevis to correct muscular imbalance of the foot and ankle. All cases were evaluated clinically and radiologically and the mean follow-up time was 3.3 years. In 88% of the cases, the corrected muscle imbalance was successful in improving and maintaining the correction. The failure was in patients who had primary weakness in the peronei and who had removed their own casts prematurely. The best results were achieved with postural deformity. The procedure of retentive treatment has the advantages of retaining the correction of all components of deformity of corrected club foot, do not disturb the normal anatomy of the foot and avoiding the complications of prolonged cast and splint retention