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CONGENITAL CLUBFOOT – LONG-TERM RESULTS OF MODIFIED TURCO’S PROCEDURE



Abstract

Introduction and Aims: This study was undertaken to assess the long-term results of treatment of clubfoot by modified Turco’s Procedure.

Method: Thirty patients with 50 feet were treated by serial casting and postero-medial release for clubfeet, by modified Turco’s procedure. Eighteen patients with 33 clubfeet were available for the final follow-up. They were followed up for an average of 13.8 years, range of 10–16 years. There were two females and 16 males. All patients underwent serial plaster correction after birth until undergoing surgical correction. All procedures were carried out by the senior surgeon, using the same technique.

All patients were operated between the ages of 6–9 months. A modified Turco’s technique was used. A longer incision extending to the lateral border of tendo-achilles was used. The abductor hallucis was completely excised. No K wire was used for holding the correction. All children were left in plaster till they started walking. A modified splint and correction shoes were used in the post-operative period. There were no wound problems in any cases, either at the time of wound closure or later on.

Results: Patients were followed with clinical and radiological examinations. Three (9%) cases each had recurrence of heel varus and forefoot adduction. Three cases had some cavus deformity, while four cases had flat foot. All patients were noted to have calf muscle wasting. The results were assessed using Ponsetti’s score. The average Ponsetti score was 87.2 (range 49–98). Two feet out of 33 had recurrence of all the deformities. There were 27 good to excellent results. The most common problem was terminal restriction of dorsiflexion, but most of the patients were happy with the results. We believe that our treatment is safe and simple, giving satisfactory results in more than 80% and with minimal complications. The results are maintained over a long follow-up period.

Conclusion: We think that this modified approach helped reduce recurrence of one of the common deformities.

These abstracts were prepared by Editorial Secretary, George Sikorski. Correspondence should be addressed to Australian Orthopaedic Association, Ground Floor, The William Bland Centre, 229 Macquarie Street, Sydney, NSW 2000, Australia.

None of the authors is receiving any financial benefit or support from any source.