We evaluated 45 patients who had 71 congenital clubfeet. The average age was 34 years (range, 25 to 42 years). 29 of these patients had been evaluated and reported on in 1980. We performed pedobarographic and electrogoniometric analyses in addition to the clinical and radiographic studies performed previously. With the use of pain and functional limitation as the outcome criteria, 35 (78 per cent) of the 45 patients had an excellent or good outcome compared with 82 (85 per cent) of 97 individuals who did not have congenital deformity of the foot. The patient's occupation, passive dorsiflexion as measured with a hand-held goniometer, the antero-posterior calcaneus-fifth metatarsal angle, the total foot pressure time integral, and the number of rapid single-limb toe-ups that could be performed were the only variables that differed significantly between the feet that had an excellent or good result and those that had a poor result (p < 0.05). A comparison of the feet that had an excellent or good outcome with those that had a poor outcome with regard to body-mass index, peak pressure under the heel, and force time integral under the metatarsal heads revealed a p value that was between 0.05 and 0.08 for each variable. The technique of treatment led to good long-term results in our patients who had clubfoot. The data suggest that a sedentary occupation and avoidance of excessive weight gain may improve the over-all long-term result. Excessive weakening of the triceps surae may predispose patients to a poor result; therefore, it is prudent to avoid overlengthening of this muscle. The outcome could not be predicted from the radiographic result.
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We evaluated 45 patients who had 71 congenital clubfeet. The average age was 34 years (range, 25 to 42 years). 29 of these patients had been evaluated and reported on in 1980. We performed pedobarographic and electrogoniometric analyses in addition to the clinical and radiographic studies performed previously. With the use of pain and functional limitation as the outcome criteria, 35 (78 per cent) of the 45 patients had an excellent or good outcome compared with 82 (85 per cent) of 97 individuals who did not have congenital deformity of the foot. The patient's occupation, passive dorsiflexion as measured with a hand-held goniometer, the antero-posterior calcaneus-fifth metatarsal angle, the total foot pressure time integral, and the number of rapid single-limb toe-ups that could be performed were the only variables that differed significantly between the feet that had an excellent or good result and those that had a poor result (p < 0.05). A comparison of the feet that had an excellent or good outcome with those that had a poor outcome with regard to body-mass index, peak pressure under the heel, and force time integral under the metatarsal heads revealed a p value that was between 0.05 and 0.08 for each variable. The technique of treatment led to good long-term results in our patients who had clubfoot. The data suggest that a sedentary occupation and avoidance of excessive weight gain may improve the over-all long-term result. Excessive weakening of the triceps surae may predispose patients to a poor result; therefore, it is prudent to avoid overlengthening of this muscle. The outcome could not be predicted from the radiographic result.
Copyright remains with the authors and publisher.