Anterior Distal Tibia Hemi-Epiphysiodesis in Relapsed Ponseti Treated Clubfoot Patients: Beware of the Rebound Phenomenon

Background/Objectives: Anterior hemi-epiphysiodesis of the distal tibia (AHDT) with an 8-plate has been proposed as treatment for clubfoot patients with recurrent equinus deformity. However, to date, clinical results have been inconsistent and particularly focused on correction during treatment. In the current project, we specifically added evaluation of outcomes at least one year after 8-plate removal.

Methods

We included Ponseti treated idiopathic clubfoot patients aged between 4 and 12 years who underwent AHDT between 2015 and 2022. Patients were assessed preoperatively at indication for 8-plate removal and if available at least one year after 8-plate removal. A senior orthopaedic surgeon specialized in clubfoot treatment determined passive ankle dorsiflexion. Furthermore, on standardized lateral radiographs, the anterior distal tibial angle (ADTA) was measured.