Radiological Outcomes Of Ligamentotaxis By Gradual Distraction And Soft Tissue Operation In Cases Of Recurrent And Resistant Club Foot

Abstract

Introduction: Clubfoot, sometimes referred to as congenital talipes equinovarus (CTEV), is a complicated malformation that manifests as cavus, adductus, varus, and equinus of the foot.  About 1 in 1000 live babies are affected, and if left untreated, it can cause severe functional impairment and irregularities in gait.

Aims: To evaluate the radiological outcomes of ligamentotaxis using gradual distraction combined with soft tissue procedures in cases of recurrent and resistant clubfoot, and to assess the effectiveness of this approach in achieving correction of deformity.

Materials & Methods: The study was a prospective interventional observational study conducted in the Orthopaedics Department of IPGME&R and SSKM Hospital, Kolkata, over a 20-month period from September 2022 to May 2024, including a total of 20 patients.

Result: In our study, post-operative radiological assessment showed significant correction in lateral view angles: talo-calcaneal increased from 14.91 ± 4.88 to 32.77 ± 4.45, while tibio-calcaneal and calcaneal pitch angles decreased from 111.11 ± 7.61 to 71.86 ± 8.7 and 35.06 ± 3.19 to 19.72 ± 4.17, respectively (P < 0.0001).

Conclusion: We came to the conclusion that the majority of patients had recurrent and resistant clubfoot, were between the ages of 24 and 30 months, were more likely to be male, and had involvement on the right side. Effective three-dimensional correction of the deformity was demonstrated by radiological results, which indicated a considerable rise in talo-calcaneal angles (AP and lateral views) and a decrease in talo-first metatarsal, tibio-calcaneal, and calcaneal pitch angles after surgery.