Abstract: Summary: The neglected clubfoot deformity is a major orthopaedic disabler of children and adults in developing nations. The bones and joints of the foot deform into fixed equinus, adductus, cavus, and supination and as patients walk on the side or dorsum of the foot, the deformity is exaggerates. This severe increasing disability physically and mentally can be significantly become better with surgical correction.
Objective: This study aimed to evaluate the triple arthrodesis and posterior tendoachilis lengthening for rigid neglected clubfoot deformities in adult patients, and its effects on clinical and radiological results.
Methods: The procedures were performed in one session on 16 feet of 12 patients [7 male, 5 female; mean age 21 (range: 15 to 30)]. K wires were used for fixation in all patients. The AOFAS (American Orthopaedic Foot and Ankle Society) ankle- hindfoot scale was used for clinical assessment.
The mean follow-up was 4 years (range: 1.5 to 6).
Results: The mean AOFAS score rose from a preoperative 36 (range: 26 to 52) to 90 (range: 86 to 94) in the final follow up (p< 0.0001). Among the 16 feet, 12 were evaluated as excellent, 4 as good. Significant clinical improvement was obtained between preoperative and postoperative surgical periods (p< 0.05). Significant improvements were observed in radiographic parameters (p< 0.0001).
At final follow-up, radiographic values were within normal physiological limits. Average union time was 7 weeks (range: 5 to 10). Pseudoarthrosis, delayed union and talus avascular necrosis was not observed in any patients.
Conclusion: The good surgical technique of triple arthrodesis and tendo achilis lengthening yields better results cosmetically and functionally in neglected clubfoot cases with severe deformities.
