Treatment of Relapsed Idiopathic Clubfoot by Complete Subtalar Release Combined With the Ilizarov Method

This study presents the clinical and radiographic outcomes of 6 feet (4 patients) with relapsed idiopathic clubfoot that were treated with a combination of subtalar release and the Ilizarov method. The mean patient age at the time of the surgery was 7.4 years (range, 4.5–10.5 years), and the mean follow-up was 5.1 years (range, 2.0–7.3 years). All cases achieved a plantigrade foot, better walking ability, and parental satisfaction with the result. Ankle joint range of motion increased from a mean of 17° (range, 10–30°) preoperatively to 45° (range, 35–65°) at final follow-up. The talocalcaneal angle improved from a mean of 26° (range, 15–34°) preoperatively to 55° (range, 47–65°) at follow-up. The mean tibiocalcaneal angle improved from 95° (range, 87–115°) preoperatively to 80° (77–83°) at follow-up, whereas the talometatarsal angle improved from a preoperative mean of −19° (range, −35 to −10°) to 3.5° (range, −5 to 7°) at follow-up. Recurrence was observed in only 1 foot with forefoot adductus, caused by a pin tract infection and early fixator removal. These cases suggest the Ilizarov method combined with subtalar release are beneficial for the treatment of relapsed idiopathic clubfoot.