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Abstract
The aim of this study was to establish a protocol for diagnosis and treatment of residual fixed forefoot adduction deformity in idiopathic clubfoot, and to evaluate the results of double column osteotomy (closing wedge cuboid osteotomy and opening wedge medial cuneiform osteotomy) in correction of the adduction, supination and cavus deformities pain relief, tolerability to orthosis and overall patient/parent vatisfaction. Twenty children (25 feet) with idiopathic clubfeet between 3-7 years of age were analyzed clinically and radiographically. All of the cases were treated by double column osteotomy with soft tissue releases(plantar fasciotomy and abductor hallucis release. Preoperative measurements of certain foot angles were compared with their postoperative values. A grading system for evaluation of the results using a point scoring system was suggested to evaluate accurately both clinical and radiographic results after a follow-up period of an average of 1.8 years. Eleven feet (44%) had excellent, ten (40%) had good, three (12%) had fair, and one (4%) had poor outcome. There was no major complication. Double column osteotomy can be consdidred superior to other types of bone surgeries in correction of the adduction, cavus and rotational deformities in idiopathic clubfoot.