Indian Journal of Physical Medicine and Rehabilitation

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VOLUME 31 , ISSUE 4 ( October-December, 2020 ) > List of Articles

ORIGINAL RESEARCH

Comparative Study of Different Incision Methods for Posteromedial Soft Tissue Release of Idiopathic Club Foot in Children: An Institutional Study

Jagannatha Sahoo

Keywords : Club foot, CTEV, Hemi-Cincinnati incision, Posteromedial soft tissue release

Citation Information : Sahoo J. Comparative Study of Different Incision Methods for Posteromedial Soft Tissue Release of Idiopathic Club Foot in Children: An Institutional Study. Indian J Phy Med Rehab 2020; 31 (4):80-85.

DOI: 10.5005/jp-journals-10066-0094

License: CC BY-NC 4.0

Published Online: 17-12-2021

Copyright Statement:  Copyright © 2020; The Author(s).


Abstract

Introduction: Various surgical procedures and techniques have been described for club foot to achieve the goal of complete anatomic restoration. As in any procedure involving multiple anatomic steps, exposure is key to a successful comprehensive release. In this study, we were doing posteromedial soft tissue release (PMSTR) in club foot through different incisions. The better approaches for the PMSTR were found out by clinical, footprint radiological evaluation. Materials and methods: This prospective study of 35 patients (57 feet) with idiopathic club foot presenting to the Balaji Institute of Surgery Research and Rehabilitation for the disabled from October 2007 to May 2009 were treated with PMSTR by three exposures. Three groups were formed as per exposure. Clinical evaluation for deformity and radiological evaluation was done in each group. Results: In the case of single, double, and hemi-Cincinnati procedures, average incision lengths were 8.3, 10.7, and 6.1 cm, respectively. Among all the post-operated feet, 25, 20, and 35.2% had <10° of dorsiflexion as well as 20, 15, and 5.9% of feet had <15° plantar flexion in case of double, single, and hemi-Cincinnati incision, respectively. In comparison with other incisions, the hemi-Cincinnati incision had less postoperative pain, better function, and less complication rate. Conclusion: Wound healing was satisfactory in the hemi-Cincinnati incision. The scar was well concealed under the strap of the sandal. In the future, the hemi-Cincinnati incision will be time-demanding in the case of a club foot.


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  1. Azar FM, Beaty JH, Canale ST. Textbook of Campbell's operative orthopeadics. 11th ed., vol. II; ch. 26 pp. 1079–1100.
  2. Dimeglio A, Bensahel H, Souchet P, et al. Classification of club foot. J Pediat Orthop (Br) 1995;4(2):129–136. DOI: 10.1097/01202412-199504020-00002.
  3. Nordin S, Aidura M, Razak S, et al. Controversies in congenital club foot: Literature review. Malaysian J Med Sci 2002;9(1):34–40.
  4. Mountney J, Khan T, Davies AG, et al. Scar quality from partial and complete wound closure using the Cincinnati incision for club foot surgery. J Pediat Orthop Part-B 1998;7(3):223–225. DOI: 10.1097/01202412-199807000-00008.
  5. Hussain SA, Khan MS, Ali MA, et al. Modified turco's postero-medial release for congenital talipes equino-varus. J Ayub Med Coll Abbottabad 2008;20(3):78–80.
  6. Simons GW, Milwaukee W. Complete subtalar release in club feet, part-II. J Bone Joint Surg 1985;67-A(7):1056–1065. DOI: 10.2106/00004623-198567070-00009.
  7. Christopher R, Brian M, Vishwas T, et al. Three-dimensional hindfoot motion in adolescents with surgically treated unilateral clubfoot. J Pediat Orthop 2005;25(5):630–634. DOI: 10.1097/01.bpo.0000164875.04517.69.
  8. Joseph B, Ajith K, Varghese RA. Evaluation of the Hemi-Cincinnati incision for posteromedial soft tissue release in club foot. J Pediat Orthop 2000;20(4):524–528. DOI: 10.1097/01241398-200007000-00019.
  9. Hsu WK, Vatia N, Raskm A, et al. Wound complication from idiopathic club foot surgery. J Pediat Orthop 2007;27(3):329–332. DOI: 10.1097/BPO.0b013e3180340d86.
  10. Hogervorst T, Vander Eijken JW. Treatment results of posterior procedures in club foot. J Pediat Orthop Part-B 1993;2(2):182–187. DOI: 10.1097/01202412-199302020-00017.
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