Posteromedial Release for Clubfoot
The patient is positioned prone. The leg was elevated and exsanguinated with the use of an Esmarch and tourniquet inflated to 220 mmHg. A posteromedial incision was made. Dissection was carried down through subcutaneous tissues and the neurovascular bundle was identified and dissected along its course and gently retracted with a vessel loop. The posterior tibial, FDL, and FHL tendons were identified and retracted. The tendon Achilles was then identified. The sheath was opened and the achilles tendon was subsequently divided in a Z-lengthening fashion. The posterior ankle capsule was identified and cleared of both posteromedial and posterolateral structures. The neurovascular bundle and tendons were protected while the capsule was incised into the tibiotalar and subtalar joints.