Resistant Talipes Equinovarus Associated with Congenital Constriction Band Syndrome

Thirty-seven clubfeet in 28 patients with concomitant congenital constriction band syndrome were reviewed. The bands were considered to be of significance if located in the calf region (zone 2). The severity of the bands was classified. Grade 1 bands involved subcutaneous tissue, grade 2 bands extended to the fascia, grade 3 bands extended to the fascia and required release, and grade 4 bands were congenital amputations. The patients were divided based on neurologic deficit. Group A consisted of 26 clubfeet without neurologic deficit and had 1.4 surgeries per clubfoot. Group B consisted of 11 clubfeet with neurologic deficit and had 3.7 surgeries per clubfoot. Children with grade 3 bands in zone 2 were most likely to have a neurologic deficit. Twenty-three clubfeet had a good clinical result, seven clubfeet fair, and seven clubfeet poor. Group B had poorer results than Group A. These feet ultimately required numerous and more extensive surgeries to obtain correction, and ultimately had a poorer result.