The Complete Subtalar Release In Ctev Correction ; Does It Address All Deformities ?

Background: Adequate surgical correction of congenital talipes equinovarus (CTEV) is a challenge to orthopedicians aiming to address all aspects of this complex foot deformity. Various exposures have been elucidated with varying results. This study discusses the Cincinnati approach advocated by McKay and whether it addresses the various aspects of clubfoot correction. Methods: Complete subtalar release using the circumferential Cincinnati incision was done in 43 feet of 30 patients aged between 6 months to 3 years. The right side was involved in 11, the left in 6 and bilateral involvement present in 13 cases. All cases were found to be resistant to correction by the conservative method proposed by Ponseti. Results: The patients were followed up for a minimum period of 2.4 years. Excellent results were seen in 18%, good in 46%, fair in 20% and poor in 14% cases. More than half of the cases had a preop talocalcaneal index of 21-30 percent which converted to 51-60 percent after surgery. Conclusion: The Cincinnati approach is ideal to achieve pantalar reduction, is cosmetically more acceptable and gives a better range of motion.