Resistant congenital club foot--one-stage posteromedial release with internal fixation. A follow-up report of a fifteen-year experience.

I have reviewed my personal experience with 240 resistant congenital club feet (176 patients) treated surgically by one-stage posteromedial release with internal fixation. The end results in the 149 feet that had a follow-up of two to fifteen years were: excellent or good, 83.8 per cent; fair, 10.7 per cent; and failures, 5.3 per cent. The best results with the least complications were in children who were operated on between the ages of one and two years. A statistical analysis of fifty-three feet with a follow-up of less than two years is reported for comparison with the results after longer follow-up to allow analysis of all the known failures and complications that have been encountered with the operation. Possible causes and prevention of fair and poor results are discussed. Modifications of the technique, which originally was reported in 1971, are described.