MANAGEMENT OF RELAPSE CLUBFOOT BY PERCUTANEOUS TENDON RELEASE WITH APPLICATION OF CORRECTIVE CAST AND ANALYSIS OF RESULT THROUGH PIRANI SCORE, PODOGRAPH FOOT BIMALLEOLAR ANGLE, RADIOLOGICAL FOOT ANGLES AND FUNCTIONAL FOOT SCORE.

Abstract

Aim:-The aim of our study to evaluate the effectiveness of percutaneous tendon release and application of corrective cast in children who had undergone serial corrective cast but had some Residual deformity Material and method :-We have included total 18 patient of Relapse clubfoot (with 22 clubfeet) in our study.The age group of patient between 6 month to 36 month.All these patient treated by percutaneous tendon release procedure and application of corrective cast.then result analysis by pirani score, podograph foot bimalleolarangle,and radiological foot angles at follow up of 1,6,12 month. Result:-pirani score result excellent in 10 feet (score<0.5),good in 10 feet(score<1.5),and fair in 2feet (score<2). Podograph foot bimalleolar angle(FBA) in 19 feet (87%)[angle >75°],FBA in 2 feet (9%)[angle70-74°],FBA in 1 feet (4% ) [angle 65-69°]. Radiological foot angleApTalocalcaneal angle mean change(7.42°) ,lateral Talocalcaneal angle mean change(7.09°) ,AP Talorst metatarsal angle mean(7.0°) , Tibiocalcaneal angle meanchange(18.66°) , Talocalcaneal index meanchange (14.65°) Laaveg ponseti and Cummings functional score excellent (85-100) in 4feet(18%),Good (70-84) in 12feet(54%), fair(60-69)in 3feet(14%), Poor (below 59)in 3feet(14%). Conclusion:-Percutaneous tendon release with application of corrective cast is safe and easy method for correction of Relapse clubfoot with less risk of wound complications,neurovascular injury and post operative scar mark.