Clubfoot Repair
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Definition
Clubfoot repair is surgery to correct a birth defect of the foot and ankle.
See also: Clubfoot
Alternative Names
Repair of clubfoot; Posteromedial release; Achilles tendon release; Clubfoot release; Talipes equinovarus - repair; Tibialis anterior tendon transfer
Description
The type of surgery that is done depends on:
Your child will have general anesthesia (asleep and pain-free) during the surgery.
Ligaments are tissues that help hold the bones together in the body. Tendons are tissues that help attach muscles to bones. A clubfoot occurs when tight tendons and ligaments prevent the foot from stretching into the right position.
To repair a clubfoot, one or two cuts are made in the skin, most often on the back of the foot and around the inside part of the foot.
- Your child's surgeon may make the tendon around the foot longer or shorter. The Achilles tendon at the back of the foot is almost always cut.
- Older children or more severe cases may need some bone cut. Sometimes, pins are placed in the foot.
- A cast is placed on the foot after surgery to keep it in position while it heals. Sometimes a splint is put on first, and the cast is placed a few days later.
Older children who still have a foot deformity after surgery may need more surgery. Also, children who have not had surgery yet may need surgery as they grow. Types of surgery they may need include:
- Osteotomy: Removing part of the bone
- Fusion or arthrodesis: Two or more bones are fused together. The surgeon uses bone from somewhere else in the body.
- Metal pins or plates may be used to hold the bones together for a while.
Why the Procedure Is Performed
A baby who is born with a clubfoot is first treated with a cast to stretch the foot into a more normal position.
- A new cast will be placed every week so the foot can be stretched into position.
- Cast changes continue for about 2 months. After casting, the child wears a brace for several years.
Clubfoot repair surgery may be needed if:
Older children or adults may need surgery if:
References
Canale ST, Beatty JH, eds. Congenital clubfoot (talipes equinovarus) In: Campbell's Operative Orthopaedics. 11th ed. Philadelphia, Pa: Mosby Elsevier; 2007:chap 26.
Review Date: 2/21/2011
Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine; David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by BEnjamin D. Roye, MD-MPH, Assistant Professor of Pediatric Orthopaedics, Children's Hospital of NY, New York, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Alternative Names
Repair of clubfoot; Posteromedial release; Achilles tendon release; Clubfoot release; Talipes equinovarus - repair; Tibialis anterior tendon transfer
After the Procedure
Depending on the surgery that is done, your child may go home on the same day or stay in the hospital for 1 to 3 days right after the surgery. The hospital stay may be longer if surgery was also done on the bones.
The child's foot should be kept in a raised position. Medicines may help control the pain.
The skin around your child's cast will be checked often to make sure it stays pink and healthy. Your child's toes also will be checked to make sure they are pink and your child can move and feel them. These are signs of proper blood flow.
Your child will have a cast on for 6 - 12 weeks. It may be changed several times. Before your child leaves the hospital, you will be taught how to take care of the cast.
When the last cast is taken off, your child's doctor will probably prescribe a brace, and may refer your child for physical therapy. The therapist will teach you exercises to do with your child to strengthen the foot and make sure it stays flexible.
Outlook (Prognosis)
After recovering from surgery, your child's foot will be in a much better position. Your child should be able to have a normal, active life, including playing sports. But the foot may be stiffer than a foot that has not been treated with surgery.
In most cases of clubfoot, if only one side is affected, the child's foot and calf will be smaller than normal for the rest of the child's life.
Children who have had clubfoot surgery may need another surgery later in life.
References
Canale ST, Beatty JH, eds. Congenital clubfoot (talipes equinovarus) In: Campbell's Operative Orthopaedics. 11th ed. Philadelphia, Pa: Mosby Elsevier; 2007:chap 26.
Review Date: 2/21/2011
Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine; David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by BEnjamin D. Roye, MD-MPH, Assistant Professor of Pediatric Orthopaedics, Children's Hospital of NY, New York, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Alternative Names
Repair of clubfoot; Posteromedial release; Achilles tendon release; Clubfoot release; Talipes equinovarus - repair; Tibialis anterior tendon transfer
Risks
Risks from any anesthesia are:
- Breathing problems
- Reactions to medicines
Risks from any surgery are:
Possible problems from clubfoot surgery are:
- Damage to nerves in the foot
- Foot swelling
- Problems with blood flow to the foot
- Wound healing problems
References
Canale ST, Beatty JH, eds. Congenital clubfoot (talipes equinovarus) In: Campbell's Operative Orthopaedics. 11th ed. Philadelphia, Pa: Mosby Elsevier; 2007:chap 26.
Review Date: 2/21/2011
Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine; David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by BEnjamin D. Roye, MD-MPH, Assistant Professor of Pediatric Orthopaedics, Children's Hospital of NY, New York, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Review Date: 2/21/2011
Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine; David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by BEnjamin D. Roye, MD-MPH, Assistant Professor of Pediatric Orthopaedics, Children's Hospital of NY, New York, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.