Complete Subtalar Release Versus One-Stage Posteromedial Release in the Surgical Treatment for Clubfeet

Abstract

Purpose: Complete subtalar release (CSTR) and one-stage posteromedial release (1S-PMR) are two major soft-tissue release procedures used in the surgical correction of club Peet. This paper compares the treatment results of these two surgical procedures, between 3 to 18 months of age with identical characteristics of deformity. Material and
Methods: 15 feet of 9 children were corrected with CSTR, and 15 feet of 12 children were operated with 1S-PMR, between 1985 and 1995. The average age of all children was 7.38 months. All of the feet were treated previously by conservative methods with manipulation and plaster cast in the first 3 months of life. A posteromedial incision and approach were used in all feet, and a supplementary lateral incision in the CSTR group. The average follow-up period was 61 (20 to 119) months in all feet.
Results: Results were graded according to Simons' criteria, and the satisfactory results were 93.3% in the CSTR group, and 66.6% in the 1S-PMR group. Three metatarsus adductus deformities were seen in the CSTR group, and 5 hindfoot equinus and 2 metatarsus adductus deformities were seen in the 1S-PMR group.
Conclusion: CSTR gave us better results compared to the 1S-PMR, in 3 to 18 months of age. In our opinion, 33.3% rate of hindfoot equinus shows the importance of lateral incisions in the surgical treatment of club foot.