0
Articles   |    
Treatment of idiopathic clubfoot. A thirty-year follow-up note

The Journal of Bone & Joint Surgery.  1995; 77:1477-1489 
5 Recommendations (Recommend) | 3 Comments | Saved by 3 Users Save Case
text A A A

Abstract

We evaluated forty-five patients who had seventy-one congenital clubfeet. The average age was thirty-four years (range, twenty-five to forty-two years). Twenty-nine of these patients had been evaluated and reported on in 1980. We performed pedobarographic and electrogoniometric analyses in addition to the clinical and radiographic studies performed previously. With the use of pain and functional limitation as the outcome criteria, thirty-five (78 per cent) of the forty-five patients had an excellent or good outcome compared with eighty-two (85 per cent) of ninety-seven individuals who did not have congenital deformity of the foot. The patient's occupation, passive dorsiflexion as measured with a hand-held goniometer, the antero-posterior calcaneus-fifth metatarsal angle, the total foot pressure time integral, and the number of rapid single-limb toe-ups that could be performed were the only variables that differed significantly between the feet that had an excellent or good result and those that had a poor result (p < 0.05). A comparison of the feet that had an excellent or good outcome with those that had a poor outcome with regard to body-mass index, peak pressure under the heel, and force time integral under the metatarsal heads revealed a p value that was between 0.05 and 0.08 for each variable. The technique of treatment led to good long-term results in our patients who had clubfoot. The data suggest that a sedentary occupation and avoidance of excessive weight gain may improve the over-all long-term result. Excessive weakening of the triceps surae may predispose patients to a poor result; therefore, it is prudent to avoid overlengthening of this muscle. The outcome could not be predicted from the radiographic result.

Figures in this Article
    This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables.

    Topics

    Accreditation Statement
    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
    CME Activities Associated with This Article
    Submit a Comment
    Please read the other comments before you post yours. Contributors must reveal any conflict of interest.
    Comments are moderated and will appear on the site at the discretion of JBJS editorial staff.

    * = Required Field
    (if multiple authors, separate names by comma)
    Example: John Doe




    Related Articles
    Related Cases
    Related Content
    Topic Collections
    Related Audio and Videos
    PubMed Articles
    Clinical Trials
    Readers of This Also Read...
    jbjs jobs
    12/22/2011
    VA - Charleston Area Medical Center
    12/22/2011
    ME - Central Maine Medical Center
    12/22/2011
    Virginia - Charleston Area Medical Center