Adults with Neglected and Recurring Clubfoot: An Approach towards Acute Surgical Correction

Abstract

In this chapter, we ought to find out the functional outcome of Talipes Equinovarus in adults. Neglected clubfoot by definition is untreated equino-cavo-adducto-varus in older children, adolescents or even adults. Untreated severe clubfoot rarely exists today in developed countries, except in some migrants from low- and middle-income countries. The study was conducted at Bashaer University Hospital and Future Hospital in Khartoum, Sudan. All surgeries were done by the same foot and ankle surgery team in both hospitals. Data was collected using a questionnaire and the functional outcome has been assessed using the American Orthopedic Foot and Ankle Society Score (AOFAS). This score was measured before surgery and one year after surgery. Results: the mean age was 19.9 ± 4.7 years. Males were 25 (62.5%) and females were 15 (37.5%). The mean preoperative AOFAS score was 37.7 ± 7.1 (poor). This score improved to 80.7 ± 13.7 (good to excellent), two years after surgery. However, this indicates a significant change in the functional outcome after the operation (p-value < 0.05). The complexity of the multi-planar foot deformity requires early intervention, good surgical planning, and the choice of the appropriate soft tissue and or bone procedures. Excellent postoperative functional outcome was found among patients aged 18 - 23 years 18 (50%) p-value: 0.021. The majority of patients 36 (90%) were fully satisfied with the operation, 2 (5%) partially satisfied and 2 (5%) were unsatisfied.

The functional outcome of this operation is comparable to other procedures like triple Arthrodesis, double osteotomies, and gradual corrections by external fixators.