Aman-ullah Khan, Qazi Masood, Saleh Tareen, Iqbal Khattak, Khalid Hassan Baloch.
Evaluation of Turco’s one stage postero-medial release for the correction of the (idiopathic) congenital talipes equinovaus.
J Pak Orthop Assoc Jan ;25(1):01-8.

Aim of the Study: The aim o the study was to find out the result of the procedure, so that the procedure can be used more safely for the correction of the clubfoot patients in the future. Place and Duration of Study: This study was conducted in the Department of Orthopedic Surgery, Sandeman Provincial Hospital, Quetta from November 1998 to December 2000. Study Design: It is prospective study. Material and Method: In this study, 32 patient (47 feet) with idiopathic CTEV, of moderate type (13 feet) and severe type (34 feet) as classified by Harrold and Walker, age ranged from 6 to 36 months (average age 15 months) were included. The patients with club feet secondary to other causes such as Polio, Spina bifida, arthrogryposis etc. were excluded. All patients were operated by Turco’s one stage PMR with internal fixation of talo-calcaneal and talo-navicular joints with K-wires. All patients were assessed cosmetically, functionally and radiologically before and after the procedure, and the results were rated according to Turco’s criteria. The period of follow-up was on average 7 months (ranged from 6 months to 24 months). Results: Out of total 32 patients (47 club feet), 23 were male (boys) and 9 were female (girls); 15 patients (48.87%) had bilateral and 17 patients (53.125%) had Unilateral clubfoot deformities. All patients were operated under general endotracheal anaesthesia, using pneumatic tourniquet at upper thigh. The results using Turco’s criteria were excellent in 24 feet (51.063%), good in 12 feet (25.531%), both excellent & good in 36 feet (76.594%), and failure was recorded in 6 feet (12.765). The bad results were due to complete recurrence of all components of the deformity in 5 feet (10.638%) and surgical over correction with severe planovalgus in one foot (2.127%). Conclusion: After the evaluation of the Turco’s one-stage PMR on short term follow-up (6 months to 24 months) average 7 months, it has been concluded that this procedure is safe and has low failure rate (12.765%). With this procedure, a plantigrade, functionally and cosmetically acceptable foot can be achieved in about 76.594% to 80% of cases in the earlier age (6 months to 36 months) group of the patients.

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