Comparison of the mid-term results of complete subtalar release by the Cincinnati and the posteromedial incisions in clubfoot
Lokman Karakurt, Oktay Belhan, Tahir Varol, Erhan Yılmaz, Erhan Serin
Fırat Üniversitesi Tıp Fakültesi Ortopedi ve Travmatoloji Anabilim Dalı, Elazığ, Türkiye
Keywords: Congenital clubfoot; complete subtalar release; Cincinnati incision; posteromedial incision.
Abstract
Objectives: Clinical and radiological results of complete subtalar release operations on idiopathic congenital clubfoot patients were compared for the Cincinati and the posteomedial incisions.
Patients and methods: Twenty-six patients (40 feet) that underwent complete subtalar release using the Cincinnati incision (group 1; 18 patients, 27 feet [12 boys, 6 girls; mean age 7.4±3.8 month; range 5-24 months]) and posteromedial incision (group 2; 8 patients, 13 feet [6 boys, 2 girls; mean age 10.1±4.3 month; range 4-16 months]) for idiopathic congenital clubfoot with at least one year followup were assessed. Tarsal bone problems, intraoperative and postoperative complications were analyzed separately.
Results: According to the Simon’s criteria, the clinical results were successful in 27 feet (100%) in group 1 and in 11 feet (85%) in group 2 (p>0.05). Radiological results were successful in 16 feet (59%) in group 1 and in two feet (15%) in group 2 (p<0.05). Superficial skin necrosis occurred in five feet (18.5%) in group 1 at the early postoperative period and all resolved with conservative treatment. Skin necrosis did not occure in group 2 (p>0.05). The cast was bivalved and opened due to soft tissue swelling at the early postoperative period in 21 feet (77.8%) in group 1 and only in one foot (7.6%) in group 2 (p<0.05).
Conclusion: Posteromedial incision is a suitable and safety incision for complete subtalar release.