Evaluating Tibialis Posterior Transfer: A Surgical Approach to Residual Clubfoot in Children Over Two Years at TOBRUK MEDICAL CENTER
DOI:
https://doi.org/10.54361/LJMR.19.1.26Keywords:
Clubfoot, congenital deformity, Tibialis Posterior Transfer, abnormal tarsal relationships, muscle balance, functional mobility, weight-bearingAbstract
Clubfoot is a congenital condition where tendons on the medial aspect of the leg and ankle become shortened and tightened, including the Achilles tendon. If left untreated, the child may appear to walk on their ankles or the sides of their feet. In severe cases, the foot may appear upside down. The primary objective of this study is to evaluate the effectiveness of the Tibialis Posterior Transfer technique in correcting abnormal tarsal relationships, maintaining reduction, and establishing muscle balance to provide functional mobility and weight-bearing ability. This descriptive study was conducted on 60 clubfeet in patients aged 2 to 10 years, with an average age of 5 years. The study was carried out from January 2016 to December 2020, with a maximum follow-up period ranging from 3 to 4 years. Among the cases, 36 involved the right foot, 11 the left foot, and 13 were bilateral. The selection criteria included cases aged over two years, neglected cases, residual deformities after conservative treatment, and cases with previously failed surgical procedures. Good results were observed in 49 cases (81.6%), while 7 cases had residual metatarsus adductus, 2 cases experienced overcorrection leading to calcaneovalgus deformity, and another 2 cases were complicated by wound dehiscence. The PMR Turco Technique and Tibialis Posterior Transfer provided excellent exposure to the subtalar and posteromedial structures without major wound healing complications. This technique not only improved foot function but also offered a more cosmetic outcome, making it a preferable surgical intervention for clubfoot management in children above the age of two, especially in cases of residual deformities following failed conservative or surgical treatment
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