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.