Relapse of clubfoot deformity after correction : effect of type of splint in unilateral cases

Abstract EN

Background and objectives Talipes equinovarus is the most common type of clubfoot deformities.

Diagnosis is mainly clinical.

The aim of treatment is to produce and maintain a plantigrade supple foot that functions well.

The treatment is usually started by conservative method by serial manipulations and casting but may need surgical correction.

After complete correction of the deformity, there is a significant risk of relapse, which can be prevented by using different types of splints for 3-4 years.

The classical splint is Denis Browne Brace in which both feet are hold together in external rotation position.

But the non compliance to this splint make adherence to it difficult.

The aim of the study was to study incidence of relapse after using different types of splints after correction of clubfoot deformity.

Methods This retrospective study included 48 patients with unilateral clubfoot who wear a splint in their foot after their deformity had been corrected.

Twenty six cases wear unilateral ankle foot orthosis while 22 cases wear foot abduction brace.

They had been followed for about 1.3-3 years.

Results In this study the incidence of relapse in patients with unilateral clubfoot was 35.4%.

thirteen (50%) out of 26 cases who used unilateral Ankle Foot Orthosis developed relapse, while 4 (18.2%) out of 22 cases who wear Foot Abduction Brace developed relapse.

The results were statistically significant.

Conclusions The use of Foot Abduction Brace is associated with low risk of relapse because it maintains the foot in external rotation position and cause stretching of posteromedial soft tissue structures while unilateral Ankle Foot Orthosis can't hold this position.