The medial sagittal approach in the treatment of the congenital clubfoot. A follow-up report of a 15-year experience.

Two hundred ninety-three resistant congenital clubfeet (203 patients) were treated surgically as follows. After posterior release of the foot through a posterolateral approach, a medial vertical incision was used to perform the medial and plantar release. Transfer of the tibialis anterior tendon to the lateral border of the foot was carried out to maintain the correction of the foot and to prevent a recurrence of the deformity. No internal fixation was used, but the medial wound was left open. Complete wound healing was observed within two weeks after surgery. The described procedure may be assimilated to a wedge opening of the medial column of the foot. The end results in the 185 feet that had a follow-up evaluation at two to 15 years were as follows: excellent or good, 90.1%; fair, 8.8%; and failure, 1.1%.