Clubfoot surgical treatment: preliminary results of a prospective comparative study of two techniques.

Abstract

Twenty patients with 30 idiopathic resistant clubfeet were operated on by the same surgeon. The mean patient age was 7.7 months (range, 3.5-19 months). Two different surgical techniques (15 posteromedial release and 15 complete circumferential subtalar release) were used during a prospective randomized study. Average follow-up was 2 years 3 months. None of the children had received previous conservative treatment. Radiologic assessment on lateral and anteroposterior radiographs included preoperative and follow-up measurements of tibiotalar, tibiocalcaneal, talocalcaneal, talo-I meta, and calcaneo-V meta angles, as well as physis morphology, talocalcaneal divergence, and location of the navicular. Before surgery, both groups were statistically similar as assessed by the Student t test. Follow-up results were also statistically similar between the groups. Functional assessment, according to Magone's score, showed global average excellent and good results in 23 feet (76.7%), with a slight but not significant difference (P = 0.77) between the two techniques. At short-term follow-up, no significant differences were found in radiologic and functional results between the two surgical procedures for idiopathic clubfoot.