Surgical management of congenital idiopathic clubfoot by twin incisions

• Main Authors: H S Varma, Alok C Agrawal, Pradeep K Singh
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2013-01-01
• Series: Journal of Orthopaedics and Allied Sciences
• Subjects: Congenital; idiopathic clubfoot; simple; two incisions
• Online Access: http://www.joas.in/article.asp?issn=2319-2585;year=2013;volume=1;issue=1;spage=18;epage=21;aulast=Varma

Background: Idiopathic clubfoot surgery is known for a number of complications, that is, skin slough and wound dehiscence medially, infection and limitation of full correction at the time of surgery which leads to excessive scar hypertrophy, recurrence of deformity, and a poor functional outcome. Many procedures done in the past have reported complications ranging from 3 to 30%. We are doing surgical correction of congenital idiopathic clubfoot by two incisions avoiding dissection of the medial skin to overcome these problems and are reporting our results. Materials and Methods: We used two incisions (a medial and a posterior incision) in cases with moderate to severe congenital idiopathic clubfoot. These were those cases who did not want to continue with Ponseti′s technique so as to avoid repeated follow-ups. Assessment of results was done by comparing preoperative and postoperative Pirani scores. Results: Our results were excellent in 7.9% (6 feet), good in 72.3% (55 feet), and fair in 15.8% (12 feet) cases. All of our cases had primary wound healing and no delayed scar related complication. Conclusions: Two incisions avoid stress on the medial skin. They permit release of all contracted structures posteromedially. We are describing this technique for its simplicity.