Surgical Correction of Residual Deformities after Ponseti Treatment of Club Feet in Walking Children

Background: Clubfoot (CF) deformity is not a uncom-mon deformity, and the majority of children show reduced height. The Ponseti serial casting (PSC) method for CF is a highly effective and minimally invasive. However, a six-year night-splinting period is difficult to comply with and predis-poses to CF persistence or recurrence. Aim of Study: Assessment of the outcomes of selective sur-gical procedures for walking CF children and were previously treated with PSC method. Patients and Methods: 35 feet with residual deformities after PSC in children aged <7 years were evaluated. Patients aged <4 years with flexible deformity received soft tissue pro-cedures. Patients aged >4 years and had rigid deformity under-went bony procedures. Postoperative (PO) follow-up entailed assessment of preoperative complaints, PO complications, and radiologic judgment of the correction of residual deformities, and the position of K-wires. PO Pirani severity scores were determined and compared to the preoperative scores. Results: Pain and the residual deformity completely dis-appeared in 80% and 82.9% of feet. PO residual hindfoot var-us, adduction of midfoot, and cavus deformities were detected in 6 feet. Two feet had wound infections that were managed conservatively in one, but the other required intervention for wound debridement and cleansing. All feet were plantigrade, with complete disappearance of preoperative difficulties. The PO Pirani scores were significantly lower, and PO radiologic estimation of various angles improved significantly than pre-operative measures. Conclusion: The selective surgical procedures for CF re-sidual deformities after PSC are an appropriate, effective, and safe management policy with a success rate >80% and mini-mum complication rate.