Clinical and Radiographical Findings of Patients with Complete Subtalar Release in Pes Equinovarus
Hasan Hilmi MURATLI, Mehmet Firat YAGMURLU, Abdullah Yalcin TABAK, Ali BICIMOGLU, Levent CELEBI
Keywords: Club foot, Talipes Equinovarus, Surgical Treatment, Complet Subtalar Release.
Aim: Complete subtalar release is the most distinguished among the soft tissue procedures applied for the treatment of pes equinovarus. In this study we aimed to evaluate the radiological and clinic results of our complete subtalar release operation. Material and
Method: The result of complete subtalar release operations in 60 feet of 39 patients with a mean age of 7.3 months (3.5-19 months) were evaluated. The follow-up was 43.5 months (25-84). In surgical approach double incisions were preferred in 52 feet, while Cincinnati incision was used in 8. The results were evaluated according to Simons' radiological and clinical criteria. Wound problems, pin loosening and development of avascular necrosis were also analysed separately.
Results: According to Simons' criteria clinically 51 feet (85%) were resulted as adequate, and 9 feet found to be inadequate. Radiologicaly 48 (80%) feet were adequate, and the remaining 12 (20%) were inadequate. In 13 feet (21%) there were combined wound problems (wound separation and infection). Pin migration was seen in 1 and another 4 early complete loosening of the pin were recorded. We have seen 2 avascular necrosis of talus and 1avascular necrosis of navicula. In 8 feet clinical pes planus was recorded.
Conclusions: Successful results may be obtained after complete subtalar release which was described first by Mc Kay and modified by Simons later. We believe that clinical and radiological correction obtained during operation combined with appropriate and persistent follow-up contributes to increment of successful results.