Evaluation of treatment outcome in congenital clubfoot by subtalar release]

This paper presents an analysis of the results of congenital clubfoot treatment by partial or complete subtalar release performed through the Cincinnati approach. Of 116 patients (142 feet) who underwent surgery in the years 1995-1996, 33 (47 feet) came in for final follow-up. The type of primary deformity was defined in only in 36 feet. There were 25 type II deformity and 1 type III deformity. Total subtalar release was performed in 39 feet. Partial subtalar release was performed in 8 feet. During the release procedure, the calcaneo-cuboid joint was not opened, but stabilized with a K-wire. Clinical results were assessed according to the Magone classification. Radiological results were assessed according to the modified criteria of Scientific Committee of the XXI Meeting of the Polish Orthopedic Society held in 1976. Talo-navicular reposition was assessed according to Napiontek. Follow-up time ranged from 40 to 54 months (mean: 48 months). The clinical assessment revealed that the analyzed group as a whole gave 82.2 points (yielding a good result). Very good results were noted in 12 feet (25%), good results in 21 (45%), satisfactory results in 7 (15%) and poor results in 7 (15%). Analysis of radiological results yielded on average 2.5 points (0-7 points). Good results were noted in 45 feet (96%) and satisfactory in 2 feet. A talo-calcaneal index of less than 55 degrees was noted in 23 feet.