Comparison of the clinical and radiological results of complet subtalar release operations by using the cincinnati and turco incisions in idiopathic congenital clubfoot

The incidence of clubfoot is 1-2 per 1000 live births. The etiology, pathological anatomy and treatment of congenital idiopathic clubfoot unfortunately are still controversial. Most authors agree that congenital clubfoot initially should be treated nonoperatively. However, when nonsurgical treatment fails to correct the deformities, surgical treatment is indicated. Complete subtalar release is a successful surgical technique that enable correction of all components of the deformity at a single session. Complete subtalar release can be made by using the Cincinnati incision, Turco incision or Carroll?s two-incision. We aimed to compare the clinical and radiological results of 26 patients (40 feet) who underwent complete subtalar release by using the Cincinnati incision (group 1) and Turco incision (group 2) for idiopathic congenital clubfoot with at least 1 year follow-up. Tarsal bone problems, intraoperative and postoperative complications were analyzed separately. According to the Simons? criteria, the clinical results were successful in 27 feet (%100) in group 1 and in 11 feet (%85) in group 2 (p>0.05). The radiological results were successful in 16 feet (%59) in group 1 and in 2 feet (%15) in group 2 (p<0.05). Superficial skin necrosis occurred in five feet (%18.5) in group 1 at early postoperative period and all resolved with conservative treatment. Skin necrosis not occured in group 2 (p>0.05). Cast was opened bivalve because of the soft tissue swelling at early postoperative period in 21 feet (%77.8) in group 1 and only 1 foot (%7.6) in group 2 (p<0.05). Radiologically unseccessful results in group 2 were attributed to the overcorrection. We thought that overcorrection in group 2 may be associated with generalized joint laxity. According to us, Turco?s posteromedial incision can be used for complete subtalar release.