Efficacy of the Ankle-Foot Orthosis in Post-Operative Management of Congenital Talipes Equinovarus
RODNEY WONG, MD AND KARL F FRANKOVITCH, MD*
The ankle-foot orthosis (AFO) proved efficacious for patients with 90 degree plantar flexion in prevention of recurrent equinus deformity when used in postoperative management of congenital equinovarus. Between 1971 and 1985 we found 202 clubfeet in 137 patients with 250 surgical procedures to the posterior ankle and hindfoot for equinus deformity. Cases associated with neuromuscular disease, arthrogryposis, and myelodysplasia were excluded. Following a 4 month cast immobilization, further management was of two types, at the discretion of the operating surgeon: footwear only (e.g. outflare shoes) for 127, and AFO (e.g. Phelps orthosis) for 123. The repeat surgery rate for the AFO-treated group (8.0%) was far lower than for the unbraced group (23.6%), indicating that the AFO plays an important role in improving results achieved following surgery to the posterior structures in the congenital club foot.
*Shriners Hospital for Crippled Children, 1645 West 8th Street, Erie, PA 16505