The adult sequelae of treated congenital clubfoot.

There are limited studies about the incidence, nature, and severity of symptoms in adults with treated clubfoot; the rate at which symptoms increase and function diminishes with advancing age; and the appropriate treatments. One of the principles of treatment of these patients includes recognition that no one description of deformities applies to all cases of painful deformity in adults after childhood treatment of congenital clubfoot. There is a spectrum of the types of deformity and a range of severity among these that must be taken into account in the decision making regarding treatment. Although the level of symptoms is very variable and ankle and hindfoot arthrodeses have the disadvantage of increasing mechanical stress and subsequent arthritis in the midfoot, arthrodesis and, to a lesser degree, osteotomy remain the mainstays of surgical reconstruction in the adult with painful deformity after treatment of congenital talipes equinovarus.