Outcomes of Eight‐Plate Epiphysiodesis for Residual Clubfoot Deformities

Objective The outcome of congenital clubfoot treatment is still challenging if the feet deformities are not completely corrected. Here we explore a minimal invasive procedure with an eight-plate implant to correct the residual forefoot adduction deformity after treatment of neglected or relapsed clubfoot. Methods We retrospectively reviewed patients with residual forefoot adduction deformity after clubfoot treatment between January 2013 and June 2016. The patients underwent temporary epiphysiodesis of the lateral column of the mid-foot, which in detail, an eight-plate was placed on each side of the calcaneocuboid joint. The foot deformities were recorded according to the weight-bearing radiographic measurements including talo-first metatarsal angle, calcaneo-fifth metatarsal angle and medial-to-lateral column length. Results A total of 13 patients (20 feet) with an average age of 7.8 years old were located with an average duration of 40.8 months follow-up (range, 28 to 54 months). The average talo-first metatarsal angle improved from 28.3 degrees (range, 19 degrees to 47 degrees) preoperatively to 8.3 degrees (range, 3 degrees to 18 degrees) and the calcaneo-fifth metatarsal angle improved from 29.1 degrees (range, 19 degrees to 40 degrees) preoperatively to 8.4 degrees (range, 0 degrees to 21 degrees) at final follow-up. The mean ratio of the medial-to-lateral column length improved from 1.14 +/- 0.06 to 1.55 +/- 0.09 with statistical significance (t = 3.566; P < 0.001). Conclusions Eight-plate epiphysiodesis is an easy and effective method for the correction of residual forefoot adduction deformity after clubfoot treatment in growing children without the need of osteotomy.