Surgical Treatment of Overcorrected Clubfoot Deformity.

Introduction: In our experience, a supramalleolar osteotomy with or without calcaneal osteotomy and midfoot osteotomy has been an effective treatment for sequelae resulting from overcorrected clubfoot deformity.

Step 1 Preoperative Assessment And Planning: Determine the treatment using the decisional algorithm in Figure 3.

Step 2 Patient Positioning: Use spinal or general anesthesia, administer intravenous antibiotics, position the patient supine, apply a tourniquet.

Step 3 Medial Approach To The Distal Part Of The Tibia: Use a medial approach to expose the distal part of the tibia.

Step 4 Supramalleolar Osteotomy: Remove the bone wedge, close the osteotomy, and use rigid plate fixation to secure the correction.

Step 5 Additional Procedures If Necessary: If necessary, perform fibular osteotomy, calcaneal osteotomy, and/or plantar flexion osteotomy of the first cuneiform.

Step 6 Closure Of All Incisions And Postoperative Care: A short leg splint is worn for two days, followed by partial weight-bearing with the ankle protected in a splint at night and a walking boot during the day for eight weeks.

Results: Between 2002 and 2009, fourteen adult patients (mean age, thirty-seven years; range, nineteen to sixty-six years) who presented with a symptomatic overcorrected clubfoot deformity were treated with a supramalleolar osteotomy.

What To Watch For: IndicationsContraindicationsPitfalls & Challenges.