Relapse rates following staged surgery in the treatment of recalcitrant talipes equinovarus: 9- to 16-year outcome study.

PURPOSE: We aimed to identify the long-term rate of relapse of deformity in a cohort of children with talipes equinovarus and to correlate it with pre-operative grading.

METHODS

Between 1988 and 1995, 120 club feet in 86 patients were surgically treated. A review at an average follow-up of 11.5 years (range 9-16 years) was performed. Of 59 of the children, 69 feet were assessed clinically and data for the remaining 20 children (30 feet) were obtained from the records. The patients were assessed using the method of Bensahel and Dimeglio but radiological analysis was omitted. Functional and morphological evaluation was recorded.

RESULTS

Initial grades were grade 2 in 26 feet (26%), grade 3 in 48 feet (49%) and grade 4 in 25 feet (25%). Relapse occurred in one case in grade 2 (3.8%), 13 feet in grade 3 (27%) and in 19 in grade 4 (76%). Since an initial review in 1997, a further 12.5% of grade 3 and 25% of grade 4 feet have relapsed. Overall function did not correlate with severity of deformity.

CONCLUSION

Relapse continues to occur after surgery during the first decade. There is a high rate of relapse (76%) in grade 4 feet.