Surgical Treatment of Overcorrected Clubfoot Deformity.

Abstract

In our experience, a supramalleolar osteotomy with or without calcaneal osteotomy and midfoot osteotomy has been an effective treatment for sequelae resulting from overcorrected clubfoot deformity. Determine the treatment using the decisional algorithm in Figure 3. Use spinal or general anesthesia, administer intravenous antibiotics, position the patient supine, apply a tourniquet. Use a medial approach to expose the distal part of the tibia. Remove the bone wedge, close the osteotomy, and use rigid plate fixation to secure the correction. If necessary, perform fibular osteotomy, calcaneal osteotomy, and/or plantar flexion osteotomy of the first cuneiform. A short leg splint is worn for two days, followed by partial weight-bearing with the ankle protected in a splint at night and a walking boot during the day for eight weeks. Between 2002 and 2009, fourteen adult patients (mean age, thirty-seven years; range, nineteen to sixty-six years) who presented with a symptomatic overcorrected clubfoot deformity were treated with a supramalleolar osteotomy. IndicationsContraindicationsPitfalls & Challenges.