Results of surgical treatment of talipes equinovarus congenita.

A series of 153 feet in 103 patients were surgically treated for idiopathic clubfeet (mean follow-up period of 10.3 years). Thirty-four percent had prior surgery before referral to the authors' institution. Functional results were excellent in 28.7%, good in 37.9%, fair in 13.1%, and unsatisfactory in 20.3%. The complication rate was 7.4%. Serious complications included translocation of os calcis, avascular necrosis of the talus, and injuries to neurovascular structures. Pain after strenuous activities was noted in 11.3% of the feet. In 9.8% of feet, limitation of activities was noted by the patients. Translocation of the hindfoot was associated with extensive subtalar release and often resulted in poor function. At operation, extensive subtalar release should only be performed with caution after failure of correction from release of other medial and posterior structures.