Paralytic congenital talipes equinovarus of unknown origin: A new entity. Multicenter study of 42 cases

SummaryBackgroundParalysis of the lateral and/or anterior leg muscles can lead to relapse of treated talipes equinovarus.HypothesisThe muscle function impairment is due to isolated permanent paralysis, and early palliative tendon transfer may prevent recurrence of the deformity.Material and methodsForty-two cases of congenital talipes equinovarus that recurred after conservative therapy were reviewed after a mean follow-up of 10 years. In 39 cases, second-line surgery was performed (posteromedial release, n = 33; and muscle transfer, n = 26). Outcomes were evaluated clinically.ResultsSeparating the cases into two groups, based on whether muscle transfer was performed, showed a statistically significant difference: muscle transfer intended to restore eversion and/or dorsal flexion of the foot was associated with significantly better functional outcomes.DiscussionIn addition to providing etiological insights, the identification of paralysis in patients with talipes equinovarus can influence treatment decisions, depending on the nature of the muscle deficiencies, with the goal of preventing recurrences. Early muscle transfer to restore eversion and/or dorsal flexion of the foot may provide the best functional outcomes by minimizing the need for soft-tissue release.Level of evidenceIV, retrospective multicentre study.