Surgical outcome with single stage procedure for neglected congenital talipes equinovarus


  • Vishal H. Chandak Ujjwal Hospital, Akashwani Chowk, Aurangabad, Maharashtra, India
  • Ketan J. Khatri Department of Orthopaedics, M.G.M. Medical College, Aurangabad, Maharashtra, India
  • Shraddha H. Chandak Ujjwal Hospital, Akashwani Chowk, Aurangabad, Maharashtra, India



Clubfoot, Neglected, Foot osteotomy, Soft tissue release


Background: Congenital talipes equinovarus is one of the commonest congenital anomalies. In developing countries like India especially in the rural population still there are many myths, culture and awareness issues regarding this deformity. Many patients get initial treatment with casting but tend loose follow ups in this prolonged treatment. To give optimal results in these scenarios, the technique for single stage procedure which includes bony and soft tissue repair gives excellent results.

Methods: In a retrospective longitudinal study, 13 children with neglected clubfeet were involved. Valid consent, clinical and radiological evaluation was done. Patients underwent single stage (bony and soft tissue) procedure described in the study. Post operatively data was collected and scoring was done as per International clubfoot study group (ICSG) at each follow ups.

Results: A total 13 children out of whom 9 were male and 4 females, all having unilateral deformity were studied. The age group was between 5-22 years (mean 13.5). Postoperatively, the children were followed at 6 months intervals. As per ICSG score 10 patients had excellent results, 3 patients had good results and none had poor results. 2 patients had minor complication - delayed wound healing (2-3 weeks).

Conclusions: Treatment of neglected clubfoot using single stage procedure dorsal close wedge osteotomy with soft tissue release has a high rate of good and excellent results, with low frequency of complications. It is a good alternative to conventional procedures for management of neglected clubfeet in developing countries, where compliance of patient is a problem.


Penny JN. The neglected clubfoot. Techn Orthop. 2005;20(2):153-66.

Ganger R, Radler C, Handlbauer A, Grill F. External fixation in clubfoot treatment - a review of the literature. J Pediatr Orthop B. 2012;21(1):52-8.3.

Ferreira RC, Stefani KC, Fonseca Filho FF, Santin RA. Correc¸ãodo pé torto congênito inveterado e recidivado pelo método deIlizarov. Rev Bras Ortop. 1999;34(9/10):505-12.

Dimeglio A, Bensahel H, Souchet P, et al. Classification of clubfoot. J Pediatr Orthop B. 1995;4:129-36.

Kirienko A, Villa A, Calhoun JH. Ilizarov technique for complex foot and ankle deformities. Philadelphia, PA:Taylor& Francis; 2004.

Kocao˘glu M, Eralp L, Atalar AC, Bilen FE. Correction of complex foot deformities using the Ilizarov external fixator. J Foot Ankle Surg. 2002;41(1):30-9.

Ahmed AA. The use of the Ilizarov method in management of relapsed club foot. Orthopedics. 2010;33(12):881.

Franke J, Grill F, Hein G, Simon M. Correction of clubfoot relapse using Ilizarov’s apparatus in children 8-15 years old. Arch Orthop Trauma Surg. 1990;110(1):33-7.

De la Huerta F. Correction of the neglected clubfoot by the Ilizarov method. Clin Orthop Relat Res. 1994;(301):89-93.

Faldini C, Traina F, Di Martino A, Nanni M, Acri F. Can selectivesoft tissue release and cuboid osteotomy correct neglectedclubfoot? Clin Orthop Relat Res. 2013;471(8):2658-65.

El-Sayed M. Ilizarov external fixation for management of severe relapsed clubfeet in older children. Foot Ankle Surg. 2013;19(3):177-81.

Makhdoom A, Qureshi PA, Jokhio MF, Siddiqui KA. Resistant clubfoot deformities managed by Ilizarov distraction histogenesis. Indian J Orthop. 2012;46(3):326-32.

Refai MA, Song SH, Song HR. Does short-term application of an Ilizarov frame with transfixion pins correct relapsed clubfoot in children Clin Orthop Relat Res. 2012;470(7):1992-9.

Devadoss A, Devadoss S, Kapoor A. Differential distraction for relapsed clubfoot deformity in children. J Orthop Surg (HongKong). 2010;18(3):342-5.

Ferreira RC, Costo MT, Frizzo GG, da Fonseca Filho FF.Correction of neglected clubfoot using the Ilizarov external fixator. Foot Ankle Int. 2006;27(4):266-73.

Saghieh S, Bashoura A, Berjawi G, Afeiche N, Elkattah R. The correction of the relapsed club foot by closed distraction. Strategies Trauma Limb Reconstr. 2010;5(3):127-35.

Cole, W.H. The treatment of claw foot. J Bone Joint Surg. 1940;22:895-908.

Graham GP, Dent CM. Dillwyn Evans operation for relapsed club foot:long term results. J Bone Joint Surg. 1992;74:445-8.

Laaveg SJ, Ponseti IV. Long term results of treatment of club foot. J Bone Joint Surg. 1980;62:23-31.

Wynne-Davies R. Talipes equinovarus:A review of eighty -four cases after completion of treatment. J Bone Joint Surg. 1964;46:464-76.






Original Research Articles