Carroll technique for the surgical treatment of idiopathic clubfoot deformity
Purpose: We evaluated the Carroll technique as a plantar and subtalar release procedure in clubfoot surgery in terms of the degree of correction achieved, complications confronted, its effects on foot mobility and outcome.\nMethods: Nineteen patients (25 feet) underwent surgical treatment for idiopathic clubfoot deformity using the Carroll technique. The average age was 11 months (range 5-32 months). All patients had grade III or IV deformities according to the Dimeglio classification. Using preoperative x-rays, we measured average anteroposterior talocalcaneal, lateral talocalcaneal, talo-1st metatarsal, and calcaneo-5th metatarsal angles as 11.5°, 13.3°, 46.5°, and 24.2°, respectively. Mean follow-up was 17 months (range 11-24 months).\nResults: No surgical wound problems occurred except for in one patient in whom an incisional detachment occurred following postoperative full cast. According to Dimeglio and Bensahel criteria, excellent results were obtained with regard to foot mobility in 14 patients and 18 feet (72%). Major residual deformities included forefoot adductus (n=2), flattened medial longitudinal arcus (n=2), pes cavus (n=1), and dorsal navicular subluxation (n=1). Postoperatively, average anteroposterior talocalcaneal, lateral talocalcaneal, talo-1st metatarsal, and calcaneo-5th metatarsal angles were measured as 37.2°, 34.7°, 2.8°, and 0.5°, respectively.\nConclusion: The pathologic anatomy should be appreciated to obtain favorable outcome after surgery for clubfoot deformity. The Carroll technique offers some significant advantages and provides good surgical correction as its principles are built on the underlying pathoanatomy. It is important that complete clinical and radiographic correction be accomplished and documented during surgery.