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Surgical treatment of clubfoot: Surgical treatment

Congenital foot deformity, clubfoot should be the principle of timely treatment. One of the most common treatments is surgical treatment, and the chances of cure are also very high. One of the surgical treatment can be chosen according to the individual different conditions and symptoms of different surgical methods.

Extensive Soft Tissue Release:

Surgical methods include Turco, Mckay, Carroll and other methods, which are aimed at releasing the soft tissues of the contracture of the foot and ankle and restoring the normal anatomical structure between the tarsal bones.

General principles of any one-stage extensive release for the treatment of clubfoot include:

1. Release the tourniquet at the completion of the procedure and electrocoagulate to stop the hemorrhage;

2. Keep the foot in plantarflexion if necessary and carefully suture the subcutaneous tissues and skin so as to avoid excessive tension on the skin;

3. At the time of the first cast change at 2 weeks after the operation, the foot can be placed in the fully corrected position.

Achilles tendon lengthening:

For children who miss the age of Achilles tendon release surgery (generally 2-3 years old) need to release the Achilles tendon, so that the Achilles bone down to the Achilles tendon lengthening, the Achilles tendon Z-shaped incision. Postoperative plaster immobilization for 6 weeks.

External tibialis anterior:

For children with early mild recurrence of clubfoot, or residual forefoot adduction deformity after treatment.

External fixation brace:

For older children (usually over 5 years old) with rigid clubfoot, where the bones of the foot have ossified and the deformity cannot be corrected by soft tissues alone, the external fixation brace technique can be used, and the brace will need to be adjusted periodically after the operation, which is basically satisfactory in appearance, but will leave residual foot and ankle joint stiffness.

Foot osteotomy orthopedics:

There are a number of surgical procedures, usually the child is older than 5 years old, according to its deformity, choose different parts of the osteotomy, can be combined with the external fixation bracket to correct the inversion deformity of the horseshoe.

Triple-joint fusion:

The indications are children over 10 years of age; the combination of three deformities: metatarsal inversion, hindfoot inversion, and plantarflexion; can be considered for this surgery.

Note:

Surgical treatment should take into account the developmental growth factors of the limb, surgical correction can be carried out in stages, and should not be too destructive.

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