Relapsed Equinovarus Complex Deformity With Long Term Follow Up

Managing relapsed Clubfoot with complex Equino varus components can be extremely challenging. Usually, most of the equinovarus deformities respond well to standard treatment protocol especially the Ponsetti method, and are widely accepted as well. However, a small percentage of relapsed complex equinovarus deformities are sometimes extremely difficult to manage. Prior to managing, proper evaluation is essential as while treating these some difficulties are inevitable. The radiological evaluation of the foot is a must to decide the extent of correction required. Such extrinsic (relapsed, neglected )clubfoot, intrinsic clubfoot have rigid hindfoot virus and equines components. If not treated early then bony changes are faster especially deformation of the talus, calcaneum, and metatarsals. Ligamentotaxsis lessens the pressure on these malpositioned, deformed tarsal, and is observed that distraction done before 6-7 years have got better results and prognosis. Fortunately, there is a gradual decline in the incidence of neglected clubfoot here in India after the child age of eight to nine years.

However, in the management of such cases the correction by ligamentotaxsis, arthrodiastasis is further better achieved when it is combined with bony procedures at a later stage if required. In the Long term follow-up of 10 years, it was assessed that after the correction of deformity a proper static phase in the assembly is essential in order to prevent any further reoccurrences. Significant radiological correction should be accessed after the removal of assembly (Talocalcaneal AP, Lat view along with talo first metatarsals angle).

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