Comparison of the soft-tissue release methods in idiopathic clubfoot

The aim of this study was to compare the clinical and radiologic results of three different surgical procedures (posterior release with lengthening of the tendo calcaneus and posterior capsulotomy, Turco's technique of poster omedial release, and Simons' technique of complete subtalar release) in idi opathic clubfoot in 77 patients who were operated on at 10 months of age or younger. The clinical examination alone is not sufficient to determine the type of the surgical intervention needed in idiopathic clubfoot; the decis ion must be supported by the radiologic parameters (anteroposterior and lat eral talocalcaneal, first metatarsal-talar, and lateral tibiotalar angles) and all the components of the multiplanar deformity must be corrected at th e same time. Simons' technique of complete subtalar release was found to be the most efficient method of surgery both functionally and radiologically in cases of idiopathic clubfoot in infants. The overcorrection of the defor mity as a consequence of the concern that the tarsal alignment did not impr ove adequately is a mistake we make not infrequently and in our opinion thi s may be avoided by taking perioperative radiographs.