EVALUATION OF THREE DIFFERENT SURGICAL PROCEDURES FOR CONGENITAL TALIPES EQUINOVARUS

Objective: To assess and compare the results of three different surgical procedures in congenital talipes equinovarus (CTEV) in children.Material and Methods: This study was conducted at Lady Reading Hospital Peshawar, from January 1993 to January 1996 and from October 2002 to February 2004. The deformity was classified into 4 grades of severity according to modified Somppi classification. Depending upon the age and the severity of the deformity, 3 different operations were performed: Posterior release, Posteromedial release and Complete subtalar release. The results were rated according to the modified Turco criteria. The patients were followed up to 2 years after surgery.Results: Study included 38 feet of 30 patients (18 males,12 females) ranging in age from 4 months to 6 years. There were 10 excellent, 17 good, 6 fair and 5 failure results. The outcome of surgery was related with the grade of the deformity and the procedure employed. In grade II clubfeet the posterior release achieved good results. In grade III, posteromedial release and in grade IVcomplete subtalar release gave good results. Most of the good or excellent results were obtained in the younger age group.Conclusion: There is no single surgical procedure, which suits all the cases of CTEV. The best surgical procedure is tailored according to the age of the patient and the severity of the deformity. Best results regarding cosmetic and functional aspects, are achieved in the younger age group.