Residual forefoot deformity predicts the need for future surgery in clubfeet treated by Ponseti casting

Abstract

Tibialis anterior tendon transfer (TATT) is performed for treatment of recurrent clubfeet. We investigated the predictability of residual adductus on the future need for TATT. A retrospective review of 143 patients with clubfoot was performed. The patients were divided into two groups: group 1 with a history of TATT and group 2 with no TATT. Heel-forefoot angle (HFA) was measured. HFA was compared between the groups. HFA was significantly different between groups 1 and 2. Residual adductus deformity in clubfeet treated by Ponseti casting is a risk factor for future need for surgical treatment.

Klumpfußtherapie nach Ponseti – aktueller Standard

“…Sie treten seltener auf, je älter das Kind ist. Als anatomische Prädiktoren für das Auftreten von Rezidiven wurden eine persistierende Spitzfußdeformität trotz Achillotenotomie [20] und die persistierende Vorfußadduktion am Ende der Gipsbehandlung beschrieben [21]…”

What is new in idiopathic clubfoot?

“…Residual forefoot adductus after completion of casting [36] and higher initial Pirani scores at the beginning of treatment [37] increase the probability of recurrent deformity and subsequent surgical intervention.…”