Surgical treatment of the idiopatic clubfoot: 15-year follow-up results

Abstract

Objective: To evaluate the late results of surgically treated idiopathic clubfeet, comparing surgical techniques and ages at the time of surgery. Methods: A total of 41 patients (66 feet) were evaluated. Eight feet were excluded due to exclusive conservative treatment and one did not met the minimum follow-up time. We analyzed the results of treatment of 57 clubfeet, with a mean follow-up time of 15 years. The incidence was bilateral in 25 patients, and unilateral in 16 patients. Soft tissues were surgically released with a postero-mid-lateral approach in 30 feet and posteromedial in 27 feet. Results were analysed accordingly to the age at the time of surgery: between 5 and 12 months or between 12 and 24 months. Results were evaluated by the Lehman method and rated as satisfactory (excellent and good), or unsatisfactory (regular and poor). Results: We have obtained 70.2% of satisfactory results (excellent: 40.4%; good: 29.8%) and unsatisfactory in 29.8% (regular: 19.3%; poor: 10.5%). Results on children operated under 12 months old were satisfactory in 62.2%, and 79% in those operated between 12 and 24 months. There was no significant difference in the results comparing the employed techniques and ages at the time of surgery. Recurrence occurred in 56% of the operated feet and complications in 47%. Conclusion: The long term follow-up results of surgically treated idiopathic clubfeet were satisfactory according to Lehman method. No statistical differences were found comparing the surgical techniques. Age at the time of the surgery did not show influence in the results.