[The indications for and limits of "extensive" posterior lysis in the surgical treatment of congenital clubfoot (talipes equinovarus supinatus)].

The authors present the preliminary results (after 4-7 years) of 69 cases of congenital torsive equino-varus-supinated foot treated operatively from 1982 to 1985 (of a total of 25% cases treated from 1982 to 1989). Both the modalities and the stages of execution of the treatment are described. After the initial clinical evaluation and the first weeks of manipulation, the feet were immobilized in corrective plaster casts, which were carefully constructed to correct the varus and supination. After 4-8 months, thorough clinical and radiographic assessment enabled the authors to plan the surgical procedure for correction of the remaining deformity, customizing it for each individual patient. There is an in-depth discussion of the stages of the "widened" posterior release procedure. Using this procedure, the authors achieved satisfactory intraoperative correction in 85% of the patients, correction which was maintained over time in 76.5% of the cases. In this way the medial stage of the surgical procedure, associated "ab initio" to the posterior release, may be reserved to a fewer number of patients (15-20%) under one year of age.