Talo-calcaneal osteotomy and soft-tissue procedures in the treatment of clubfeet. II. Results in 36 surgically treated feet.
Thirty-six refractory or recurrent clubfeet were treated by correction osteotomy through the talar neck and calcaneus in combination with various soft tissue procedures. The aim of the osteotomies was to correct the pronounced deformities observed at simultaneous arthrography of the talocrural and talonavicular joints. The soft tissue procedures were carried out to facilitate the correction and to prevent recurrence by creating muscle balance. Twenty-four clubfeet were idiopathic and 12 were secondary to neurological or other diseases. The observation period since the osteotomies were performed was, at the time of writing, 1.5 to 5.5 years (median 3 years). A brief report of the indications and methods of operation is given. Good or fair results were achieved in 21 of the 24 idiopathic clubfeet, while the results were somewhat poorer in the secondary clubfeet. A correlation between the degree of arthrographically demonstrated talar deformity and the results of surgical treatment was found. The main reason for a poor result was incomplete correction of the most extreme talar deformity in combination with marked preoperative joint rigidity.