International Orthopaedics

, Volume 11, Issue 3, pp 189–192 | Cite as

The surgical management of resistant club foot by rotation skin flap and extensive soft tissue release

  • R. L. Mittal
Article

Summary

Resistant club foot remains an unsolved problem because of the complex aetiological and pathological factors, and is still seen quite frequently, especially in developing countries. The posteromedial skin contracture is a potent deforming force which is responsible for many failures or relapses. I report the results of an operation in which a rotation skin flap was combined with an extensive soft-tissue release. The age of the children was from 9 months to 10 years. The follow-up period was from one to 9 years with an average of 43 months, and in 50 cases for more than 5 years. I consider that the outcome has been excellent or good in 94 out of 100 feet.

Key words

Resistant club foot Rotation skin flap Extensive soft tissue release 

Résumé

Le pied bot invétéré demeure un problème mal résolu en raison de la complexité des facteurs étiologiques et anatomiques et il est encore bien souvent rencontré, notamment dans les pays en voie de développement. La rétraction cutanée postéro-interne représente un puissant élément de la déformation, qui est responsable de bon nombre d'échecs ou de récidives. Nous rapportons les résultats d'une opération qui associe un lambeau cutané de rotation à la libération des parties molles. L'âge des enfants était compris entre neuf mois et dix ans. Le recul est de un à neuf ans, avec une moyenne de 43 mois. Cinquante enfants ont été suivis plus de cinq ans. Les résultats sont excellents ou bons dans 94% des cas.

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References

  1. 1.
    Beatson TR, Pearson JR (1966) A method of assessing correction in club foot. J Bone Joint Surg [Br] 48: 40–50Google Scholar
  2. 2.
    Berman A, Gartland JJ (1971) Metatarsal osteotomies for the correction of adduction of forepart of foot in children. J Bone Joint Surg [Am] 53: 498–506Google Scholar
  3. 3.
    Bertelsen A (1957) Treatment of congenital club foot. J Bone Joint Surg [Br] 39: 599Google Scholar
  4. 4.
    Bost FC, Schottetaedt KR, Larsen LS (1960) Plantar dissection. An operation to release the soft tissue in recurrent and recalcitrant talipes equinovarus. J Bone Joint Surg [Am] 42: 151–164Google Scholar
  5. 5.
    Kendrick RE, Sharma NK, Hassler W, Herndon CH (1970) Tarsometatarsal mobilisation for resistant adduction of forepart of the foot. J Bone Joint Surg [Am] 52: 61–70Google Scholar
  6. 6.
    Kite JH (1972) Non-operative treatment of congenital club foot. Clin Orthop 84: 29–38Google Scholar
  7. 7.
    McCauley JC (1966) Club foot: history of the development and the concept of pathogenesis and treatment. Clin Orthop 44: 51–56Google Scholar
  8. 8.
    McCauley JC (1972) The history of conservative and surgical methods of club foot treatment. Clin Orthop 84: 25–28Google Scholar
  9. 9.
    Mittal RL, Makhni SS, Sidhu GS (1981) Morbid anatomy of congenital club foot. Ind J Orthop 15: 129–135Google Scholar
  10. 10.
    Shapiro F, Glimcher MJ (1979) Gross and histological abnormalities of congenital club foot. J Bone Joint Surg [Am] 61: 522–530Google Scholar
  11. 11.
    Singer M, Fripp AT (1958) Tibialis anterior transplant in congenital club foot. J Bone Joint Surg [Br] 40: 252–255Google Scholar
  12. 12.
    Steytler JCS, Van der Walt ID (1966) Correction of resistant adduction of the forefoot in congenital metatarsus varus by metatarsal osteotomy. Br J Surg 53: 558–560Google Scholar
  13. 13.
    Tayton K, Thompson P (1979) Relapsing club feet. J Bone Joint Surg [Br] 61: 474–480Google Scholar
  14. 14.
    Turco VJ (1971) Surgical correction of resistant club foot. J Bone Joint Surg [Am] 53: 477–497Google Scholar
  15. 15.
    Zirkle LG, Westin GW (1972) X-ray evaluation of foot deformities. J Bone Joint Surg [Am] 54: 1584–1585Google Scholar

Copyright information

© Springer-Verlag 1987

Authors and Affiliations

  • R. L. Mittal
    • 1
  1. 1.Department of Orthopaedics, Government Medical CollegeRajendera HospitalPatiala-PunjabIndia

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