Journal of Children's Orthopaedics

, Volume 1, Issue 2, pp 115–119 | Cite as

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

  • Michael G. Uglow
  • Needhirajan Senbaga
  • Richard Pickard
  • Nicholas M. P. Clarke
Original Clinical Article



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.


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.


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.


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


Talipes Clubfoot Relapse Talipes Surgery 


  1. 1.
    Uglow MG, Clarke NMP (2000) The functional outcome of staged surgery for the correction of talipes equinovarus. J Pediatr Orthop 20:517–523PubMedGoogle Scholar
  2. 2.
    Uglow MG, Clarke NMP (2000) Relapse in staged surgery for congenital talipes equinovarus. J Bone Joint Surg (Br) 82(5):739–743CrossRefGoogle Scholar
  3. 3.
    Bensahel H, Dimeglio A Souchet PH (1995) Final evaluation of clubfoot. J Pediatr Orthop B 4:137–141CrossRefPubMedGoogle Scholar
  4. 4.
    Dimeglio A, et al (1995) Classification of clubfoot. J Pediatr Orthop B 4:129–136CrossRefPubMedGoogle Scholar
  5. 5.
    Carroll NC, McMurtry R, Leete SF (1978) The pathoanatomy of congenital clubfoot. Orthop Clin North Am 9:225–232PubMedGoogle Scholar
  6. 6.
    Sobel E, Giorgini RJ, Michael R, Cohen SI (2000) The natural history and longitudinal study of the surgically corrected clubfoot. J Foot Ankle Surg 39(5):305–320CrossRefPubMedGoogle Scholar
  7. 7.
    Hutchins PM, Foster BK, Paterson DC, Cole EA (1985) Long-term results of early surgical release in clubfeet. J Bone Joint Surg Br 67:791–792PubMedGoogle Scholar
  8. 8.
    Hudson I, Catterall A (1994) Posterolateral release for resistant clubfoot. J Bone Joint Surg Br 76:281–284PubMedGoogle Scholar
  9. 9.
    Esser RD (1994) The medial sagittal approach in the treatment of the congenital clubfoot. A follow-up report of a 15 years experience. Clin Orthop 302:156–163PubMedGoogle Scholar
  10. 10.
    Porter RW (1987) Congenital talipes equinovarus II. A staged method of surgical management. J Bone Joint Surg Br 69(5):826–831PubMedGoogle Scholar
  11. 11.
    Magone JB, Torch MA, Clark RN, Kean JR (1989) Comparative review of surgical treatment of the idiopathic clubfoot by three different procedures at Columbus Children’s Hospital. J Pediatr Orthop 9:49–58CrossRefPubMedGoogle Scholar
  12. 12.
    Kranicz J, Than P, Kustos T (1998) Long term results of the operative treatment of clubfoot: a representative study. Orthopaedics 21(6):669–674Google Scholar
  13. 13.
    Bjonness T (1975) Congenital clubfoot. A follow-up of 95 persons treated in Sweden from 1940–1945 with special reference to their social adaption and subjective symptoms from the foot. Acta Orthop Scand 46(5):848–856CrossRefPubMedGoogle Scholar
  14. 14.
    Laaveg SJ, Ponseti IV (1980) Long-term results of treatment of congenital clubfoot. J Bone Joint Surg Am 62(1):23–31PubMedGoogle Scholar

Copyright information

© EPOS 2007

Authors and Affiliations

  • Michael G. Uglow
    • 1
  • Needhirajan Senbaga
    • 1
  • Richard Pickard
    • 1
  • Nicholas M. P. Clarke
    • 1
  1. 1.Trauma and Orthopaedics, Southampton General HospitalSouthampton University Hospitals NHS TrustSouthamptonUK

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