Clubfoot repair
Alternative Names
Repair of clubfoot; Posteromedial release; Achilles tendon release; Clubfoot release; Talipes equinovarus - repair; Tibialis anterior tendon transfer
Definition
Clubfoot repair is surgery to correct a birth defect of the foot and ankle.
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:
- The cast or other treatments do not fully correct the problem
- The problem comes back
Older children or adults may need surgery if:
- A clubfoot was never treated
- They still have foot problems after treatment
Risks
Risks from any anesthesia are:
- Breathing problems
- Reactions to medicines
Risks from any surgery are:
- Bleeding
- Infection
Possible problems from clubfoot surgery are:
- Damage to nerves in the foot
- Foot swelling
- Problems with blood flow to the foot
- Wound healing problems
Before the Procedure
Your child's doctor may:
- Take a medical history of your child
- Do a complete physical examination of your child
- Do x-rays of the clubfoot
- Test your child's blood (do a complete blood count and check electrolytes or clotting factors)
Always tell your child's doctor or nurse:
- What drugs your child is taking
- Include drugs, herbs, and vitamins you bought without a prescription
During the days before the surgery:
- About 10 days before the surgery, you may be asked to stop giving your child aspirin, ibuprofen (Advil, Motrin), or any other drugs that make it hard for your child's blood to clot.
- Ask your child's doctor which drugs your child should still take on the day of the surgery.
On the day of the surgery:
- Usually, your child will not be able to drink or eat anything for 4 - 6 hours before the surgery.
- Only give your child a small sip of water with any medicine your doctor told you to give your child.
- Your child's doctor or nurse will tell you when to arrive for the surgery.
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
Kelly DM. Congenital Anomalies of the Lower Extremity. In: Canale ST, Beaty JH, eds. Campbell's Operative Orthopaedics. 12th ed. Philadelphia, Pa: Mosby Elsevier; 2012:chap 29.