The Residual Forefoot Adduction after Clubfoot-Surgery / 대한정형외과학회잡지

ABSTRACT

PURPOSE: To analyze the incidence and influencing factors of residual forefoot adduction after clubfoot-surgery. MATERIALS AND METHOD: A total of 133 clubfeet of 94 patients that had been surgically treated more than 3 years ago were followed up. For comparison purposes, we divided them into 3 groups. The first group was treated using a one-stage posteromedial release (PMR, 84 feet), the second group by posterolateral release (PLR, 34 feet), and the third group by medial release and lateral column shortening (Lichtblau, 34 feet). The forefoot adduction was characterized by Bleck's method and the effects of influencing factors, such as sex, laterality, methods of operation, and age at the time of operation were examined. Preoperative and postoperative calcaneocuboidal angles were also measured. RESULT: 40.2% of residual forefoot adduction was observed. Persistent grade 2 calcaneocuboidal malalignment showed 81.4% residual forefoot adduction. Forefoot adduction was unlikely to persist following posteromedial release procedure in the 1 to 2 year old age group. CONCLUSION: Age at the time of operation and the correction of calcaneocuboidal malalignment were significant factors for the development of residual forefoot adduction.