Congenital talipes equinovarus

ABSTRACT

To determine the functional outcome of one stage posteromedial release in congenital clubfoot in terms of functional and radiological assessment. Forty five patients having clubfoot deformity were included in the study. Fifteen patients had bilateral deformities. The outcome was evaluated by functionally assessing the foot in the last review visit [at the end of 14th week of surgery] using the rating system of McKay, which has ten categories and has a maximum score of 180 points. It rates the outcomes as excellent good, fair, poor and failure [Fig -1]. Radiological assessment is made by measuring various angles on anteroposterior and lateral radiograph of the foot with gonometer at 3, 6, 10 and 14 weeks after release [Table -II]. The values of talocalcaneal angle [measured during every visit] on AP and lateral views will be summated to yield talocalcaneal index, and an index of >40 degree was taken as normal. Forty five patients included in the study with clubfoot deformity. Out of these patients, 33 [73.33%] were males and 12 [26.66%] were females [table -I]. They were graded according to the McKay rating system. In this short term follow up of one year, the following results were observed. Thirty-nine [65%] patients had excellent results, 11 [18.33%] patients had good results, 3 [5%] patients had fair results and 7 [11.66%] patients had poor results [Fig-1]. No case can be labeled as failure. Mild to moderated clubfoot deformities can be successfully treated in children up to five years of age by one stage postero-medial release