Clubfoot repair
Definition
Clubfoot repair is surgical correction of a birth deformity of the foot and ankle (clubfoot).
Alternative Names
Repair of clubfoot; Foot tendon release; Clubfoot release
Description
The type and extent of surgery depends on the how severe the deformity is. The defect involves tight tendons and ligaments in the foot and ankle. The surgery involves lengthening some tendons and releasing tight ligaments to place the bones and joints in normal positions. Sometimes, pins are temporarily placed in the foot and a cast is applied after surgery to maintain its position while it heals.
Why the Procedure is Performed
The newborn's clubfoot is initially treated with casts. The tendons, ligaments, and bones are still quite flexible in a newborn and are somewhat easy to reposition. The foot is stretched into a more normal position and a light-weight cast is applied to retain the corrected position.
The cast will be removed every week so the foot can be further stretched into better position and maintained with a new cast. This series of casting is continued for approximately 2 months, and is successful in at least 50 - 95% of cases.
If the casts do not provide enough correction of the clubfoot, surgery is considered. Surgery is also considered if the clubfoot is recurrent (happens after being treated previously), or if it is associated with neuromuscular disorders or syndromes.
Risks
Risks for anesthesia include the following:
- Reactions to medications
- Breathing problems
Risks for surgery include the following:
Outlook (Prognosis)
If surgery is necessary, the foot usually becomes quite functional. Physical therapy may help keep the foot in good position and help improve function and flexibility. Bracing after surgery is frequently necessary.
In most cases, the child's foot and calf may remain smaller than normal throughout life. The surgically corrected foot is generally very functional, although typically somewhat stiffer than a normal foot or one treated without surgery.
Recovery
The child will stay in the hospital for approximately 1 - 3 days after surgery. The foot will be kept elevated. Medications may be used for pain. The skin around the cast and the toes will be checked frequently to make sure that proper circulation is maintained.
Before leaving the hospital, the parent will be taught how to take care of the cast.
Possible complications include skin irritation, infection, problems with swelling or circulation to the foot.
Review Date:
12/5/2006
Reviewed By:
Thomas N. Joseph, MD, Private Practice specializing in Orthopaedics, subspecialty Foot and Ankle, Camden Bone & Joint, Camden, SC. Review provided by VeriMed Healthcare Network.
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