Gait analysis in children with severe clubfeet: early results of physiotherapy versus surgical release

Abstract

Ninety children between the ages of 2 and 3 years with 127 clubfeet underwent gait analysis. Fifty-one feet had undergone posteromedial releases, 52 feet had no surgery following correction of the deformity using the French physical therapy program, and 24 feet had either tendo Achilles lengthening or posterior releases following physical therapy. Persistent internal rotation of the foot during gait was the most frequent gait disturbance and was seen in all treatment groups. Limited ankle dorsiflexion was most common in the nonoperated feet, while calcaneus deformity occurred in the posteromedial release group. Ankle motion during gait was normal in 54% of nonoperated feet compared with 39% of feet that had posteromedial releases. While gait abnormalities were common in all clubfeet, fewer deviations were documented in feet treated with physical therapy that did not require surgery. Aggressive release leads to a higher likelihood of abnormal ankle motion and internal rotation during gait.