Growth Disturbance of the Distal Tibia in Patients With Idiopathic Clubfeet: Ankle Valgus and Anteflexion of the Distal Tibia

Abstract

Level III.

What is new in idiopathic clubfoot?

“…Burghardt et al analyzed the radiographs of 65 patients after surgical treatment of their clubfoot with an average of 10 years follow-up. The authors noted a significant talar flattening, distal tibia valgus, and anteflexion deformity in a large proportion of patients [47]. It is now widely accepted that primary surgical management of idiopathic clubfoot is no longer the standard of care.…”

“…Long-term follow-up studies indicate that surgically treated clubfeet are more likely to be painful and stiff [45][46][47]. One study suggests decreased walking capacity in surgically treated clubfeet compared to healthy age-matched controls [48].…”

Radiological tarsal bone morphology in adolescent age of congenital clubfeet treated with the Ponseti method

“…Additionally, it is unknown whether severe tarsal bone deformities, often observed after primary surgical therapy of clubfeet, occur or persist after the Ponseti treatment [11][12][13][14]. Clinical experience with residual clubfoot deformities in adult patients shows that in many cases the condition of the ankle will determine the long-term clinical outcome [15][16][17].…”

“…Clinical experience with residual clubfoot deformities in adult patients shows that in many cases the condition of the ankle will determine the long-term clinical outcome [15][16][17]. In this context, supramalleolar valgus misgrowth and dysplasia of the talus with a significantly reduced or flattened articular surface of the trochlea tali ("flat top talus") have often been observed after initial surgical treatment of clubfeet and were associated with poor clinical outcome [12,14,18]. Comparable deformities might also affect the outcome after therapy with the Ponseti method.…”

Radiographic Prognostic Factors for Selective Soft Tissue Release After Ponseti Failure in Young Pediatric Clubfoot Patients

“…Extensive corrective surgery reportedly has a high success rate but is also limited by the fact that it can produce stiff and poorly functioning feet. 4,7,34…”