A prospective study on dynamic supination defect of clubfoot treated by tibialis anterior tendon transfer

Abstract

Background: Congenital talipes equinovarus (CTEV), commonly known as clubfoot, is a prevalent congenital deformity that can result in significant physical challenges if not treated effectively. The Ponseti method is widely recognized as the initial treatment of choice for idiopathic clubfoot; however, the relapse rate remains considerable. Dynamic supination defect is a common manifestation of relapse, which can be effectively addressed through tibialis anterior tendon transfer (TATT). Objective: This prospective study aimed to evaluate the functional and radiological outcomes of TATT in children aged 2 to 7 years who present with a residual dynamic supination defect following initial CTEV correction via the Ponseti method. Methodology: The study included 11 patients (13 feet) treated at the Orthopaedic Department of K R Hospital, Mysore, between August 2022 and May 2024. TATT was performed, and outcomes were assessed using the Dimeglio scoring system and radiological measurements of talo-calcaneal and talo-first metatarsal angles. Results: The study observed significant improvements in Dimeglio scores and radiographic angles at 6 months and 1 year postoperatively, indicating effective correction of the deformity. Complications were minimal, and patient satisfaction was high, with most feet achieving a functional, pain-free state. Conclusion: TATT is an effective surgical intervention for correcting dynamic supination in children with relapsed idiopathic clubfoot, demonstrating substantial improvements in foot function and alignment.