Avascular necrosis of the body of the talus after combined medial and lateral release of congenital clubfoot.

A retrospective study was made of 203 patients with 321 congenital clubfoot deformities who had at least one operative procedure at the Shriner's Hospital in Greenville, South Carolina, in a period from 1944 to 1973. The five cases of avascular necrosis of the talus occurred among the 35 patients having combined medial and lateral releases. These five clubfeet were recurrent and recalcitrant and required extensive soft tissue release to achieve sustained correction. It is recommended that dissection of the subtalar joint, except at the talonavicular joint, be avoided and that extensive lateral ankle dissection, especially when the sinus tarsi is included, should not be performed simultaneously with the medial release unless absolutely necessary to achieve the desired anatomic relationship.