Clinical Analysis and Treatment of Congenital Clubfoot

Chun, Shi Wook

Abstract

Since congenital clubfoot is not a single or uniform entity, one cannot expect a consistently favorable response from a single or uniform method. And one person's ideas or methods of therapy either conservative or operative would be noted insufficient or not applicable to all cases. This report is based upon analysis of records for 44patients seen at National Medical Center from 1971 to 1980. 44 patients with 68 congenital clubfood were seen at the Outpatient Department and 26 in-patients with 40 congenital clubfoot were treated, and the average follow-up period was II. 6 months. If the clubfoot was found early conservative method was applied initially whether it was the flexible or rigid type, and surgery was applied in children whose deformith had not responded to conservative treatment or had been neglected for a long time and proved to be rigid. The results were as follows, 1. Among 68 clubfoot, equinovarus was 64, and calcaneovalgus was 4. Of the 44 patients, 32 were male and 12 were female (2.7:1). 2.Bilaterat involvement was in 24 and unilateral in 20 patients. 3. 35 cases(79. 5%) were idiopathic, and 9 were associated with other congenital abnormalities. Of 40 clubfoot, supple type were 24 feet. and rigid type were 16 feet. In patients under 3 months of age, conservative treatment was found to be quite adequate to obtain good result. 5. 24 feet were treated with a serial cast for the average period of 8 weeks, with the result of 18 good, 3 fair, and 3 poor. To obtain good result, patient's tolerance, parent's eooperation and doctor's skill were all necessary. 6. 18 feet graded good had T-C index of more than 47. Surgical correction was applied in l6 feet of rigid type with the result of 10 good, 2 fair, and 2 poor. Various surgical methods were to be applied according to the age of patients and the main pathology. 8. Modified Turco operation was performed ia 8 patients(6 feet) at the age of 6 months, 8 months and 10 months respectively, and this one stage posteromedial release with K-wire fixation showed the best results in those age groups.