Abdul Hannan, Muhammad Iqbal Mirza, Muhammad Khalid Syed, Syed Faraz-ul Hassan Shah Gillani, Muhammad Tajammal Butt, Usman Zaffar Dar.
Evaluation of single stage posteromedial soft tissue release for treatment of idiopathic severe club foot.
Pak J Med Health Sci Jan ;13(4):922-4.

Background: Club Foot is a multifaceted deformity of foot. Most Orthopedic surgeon agree that the initial treatment of a clubfoot deformity should be non -operative and should begin in the first week of life. In our setup the presentation of congenital club feet is mostly delayed. Reasons behind this late pre sentation are the large numbers of domiciliary child births attended by traditional birth attendants for whom an early referral to a qualified Orthopedic surgeon is not always possible. Aim : The outcome of single stage posteromedial soft tissue releases for management of severe clubfoot. Methods: This case series was done at Department of Orthopedic Surgery and Traumatology unit –I (DOST -I), King Edward Medical University / Mayo Hospital Lahore. In one -year duration, we included 85 cases of sever club foot child <01year of age of both gender using non -probability, convenient sampling. The patients were admitted in the ward before surgery and pre -operative Pirani scoring was done. All the patients underwent one stage posteromedial release by a single surgical team under tourniquet control under general anesthesia. All patients were followed -up till 6 months and were assessed by using Pirani scoring criteria to assess the effectiveness of the treatment. Results: Out pf total 85 cases, the mean age of patients was 7.49 ± 2.87 month with minimum and maximum age of 1 and 11.50 months. In this study there were 58(68.2%) male and 27(31.8%) were females with male to female ratio 2.14:1. Mean Pirani score before treatment was 8.25 ± 0.61 while after treatment mean Pirani score was 0.98±0.9 with minimum score 0 and maximum 3 score. After applying paired sample t -test we found significant reduction in Pirani score after treatment, p -value < 0.001. Conclusion: Through this study we found that single stage posteromedial soft tissue release for management of severe clubfoot is an effective method of clubfoot correction.

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