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KMID : 0361620190540060547
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Journal of the Korean Orthopaedic Association
2019 Volume.54 No. 6 p.547 ~ p.556
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Long-Term Results of Surgical Treatment for the Idiopathic Clubfoot
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Kim Hui-Taek
Kim In-Hee
Cho Yoon-Jae
Ahn Tae-Young
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Abstract
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Purpose: This study evaluated the results of surgical treatment for residual or recurrent deformity after the conservative treatment of idiopathic clubfoot.
Materials and Methods: Fifty-one cases (32 patients), who were followed up to skeletal maturity, were reviewed retrospectively. The mean age at the last follow-up was 18.7 years. The surgical options included selective or comprehensive soft tissue release, tendon lengthening and transfer, and various types of osteotomy. The radiology measurements included the talocalcaneal angle and talo-first metatarsal angle in the anteroposterior (AP) view, and the talocalcaneal angle and calcaneal pitch in the lateral view. The radiology measurements were compared with the normal values for adults. The clinical evaluations were made using the ankle-hindfoot score and the midfoot score of the American Orthopaedic Foot and Ankle Society (AOFAS): excellent (>85), good (71?85), pair (56?70), and poor (<56).
Results: At the last follow-up, the percentages of the 51 cases, whose parameter values fell within the normal ranges were as follows: in the AP view, 41.2% (talocalcaneal angle); and 90.2% (talo-first metatarsal angle). In the lateral view, the percentage was 84.3% (talocalcaneal angle). For the calcaneal pitch, the percentages were 61%. The mean AOFAS score was 88.1±10.7 on the ankle-hindfoot score and 86.7±11.5 on the midfoot score.
Conclusion: The long-term outcome of patients with idiopathic clubfoot, who underwent surgical treatment after conservative treatment, was found to be 43%?90% of the normal range of radiographic indices. Clinically, the mean AOFAS scores were “excellent”. Therefore, a satisfactory result can be obtained by analyzing the elements of deformity more accurately and then using the selective operation method, even if the non-surgical correction method fails.
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KEYWORD
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clubfoot, surgery
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