An observational study in Clubfoot Deformity and Forefoot Adductus, sponsored by Cairo University. Completed at 1 site in Egypt. Open to participants aged 4 Years to 10 Years. Per ClinicalTrials.gov, last updated 2026-06-02.
Sponsored by Cairo University · Observational
Purpose:
The purpose of this prospective clinical study is to evaluate the radiographic outcomes, effectiveness, and safety of lateral calcaneocuboid guided growth using an extra-periosteal tension-band plate (eight-plate) to correct residual forefoot adduction (often referred to as a "bean-shaped foot") in growing children with relapsed idiopathic clubfoot.
Condition and Intervention:
Residual forefoot adduction remains a challenging deformity following primary infant clubfoot treatment. While traditional management often relies on invasive double-column midfoot osteotomies-which carry risks of permanent joint stiffness, nonunion, and cartilage damage-this study investigates a minimally invasive alternative. Eligible pediatric patients (ages 4 to 10 years) with symptomatic, flexible or partially flexible residual forefoot adduction undergo temporary lateral calcaneocuboid epiphysiodesis using an extra-periosteal eight-plate and two cannulated screws.
Methodology \& Expected Outcomes:
Patients are clinically categorized into simple relapses (isolated, flexible forefoot adduction) and complex relapses (rigid deformities associated with hindfoot varus or equinus) to evaluate treatment efficacy across different deformity profiles. Radiographic parameters, including the anteroposterior talo-first metatarsal angle (T1MA), calcaneo-fifth metatarsal angle (C5MA), and the medial-to-lateral (M/L) column ratio, are tracked postoperatively every 3 months. The primary goal is to determine if restricting lateral midfoot column growth allows the shorter medial column to catch up proportionally, thereby restoring normal foot alignment and preserving joint range of motion without the morbidity of structural bone cuts. Patients are monitored for complications, such as hardware loosening, and are tracked long-term until definitive skeletal maturity.
Purpose:
The purpose of this prospective clinical study is to evaluate the radiographic outcomes, effectiveness, and safety of lateral calcaneocuboid guided growth using an extra-periosteal tension-band plate (eight-plate) to correct residual forefoot adduction (often referred to as a "bean-shaped foot") in growing children with relapsed idiopathic clubfoot.
Condition and Intervention:
Residual forefoot adduction remains a challenging deformity following primary infant clubfoot treatment. While traditional management often relies on invasive double-column midfoot osteotomies-which carry risks of permanent joint stiffness, nonunion, and cartilage damage-this study investigates a minimally invasive alternative. Eligible pediatric patients (ages 4 to 10 years) with symptomatic, flexible or partially flexible residual forefoot adduction undergo temporary lateral calcaneocuboid epiphysiodesis using an extra-periosteal eight-plate and two cannulated screws.
Methodology \& Expected Outcomes:
Patients are clinically categorized into simple relapses (isolated, flexible forefoot adduction) and complex relapses (rigid deformities associated with hindfoot varus or equinus) to evaluate treatment efficacy across different deformity profiles. Radiographic parameters, including the anteroposterior talo-first metatarsal angle (T1MA), calcaneo-fifth metatarsal angle (C5MA), and the medial-to-lateral (M/L) column ratio, are tracked postoperatively every 3 months. The primary goal is to determine if restricting lateral midfoot column growth allows the shorter medial column to catch up proportionally, thereby restoring normal foot alignment and preserving joint range of motion without the morbidity of structural bone cuts. Patients are monitored for complications, such as hardware loosening, and are tracked long-term until definitive skeletal maturity.
79 studies on the registry are indexed under Clubfoot; 18 are open to participants now.
This study's enrollment of 15 is below the median of 55 across 29 observational studies indexed under Clubfoot.
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diatric patients presenting with symptomatic, flexible or partially flexible residual forefoot adduction (the clinical "bean-shaped foot") who had failed prior conservative management following primary treatment for idiopathic congenital clubfoot. The study cohort was recruited from a tertiary pediatric orthopedic center and followed prospectively to evaluate the outcomes of lateral column growth modulation.
the children's age should be from 4 to 10 years old. children with clubfoot who still had symptomatic residual forefoot adduction
Exclusion Criteria:
Pediatric patients presenting with isolated, flexible residual forefoot adduction following primary infant clubfoot treatment. These patients do not exhibit rigid multi-planar deformities or associated significant hindfoot varus.
Procedure: Lateral Calcaneocuboid Guided Growth (Eight-Plating)
Pediatric patients presenting with rigid midfoot residual adduction components accompanied by fixed hindfoot varus or fixed equinus deformities following primary infant clubfoot treatment
Procedure: Lateral Calcaneocuboid Guided Growth (Eight-Plating)
emporary lateral calcaneocuboid joint epiphysiodesis using a tension-band plate (eight-plate). Under fluoroscopic guidance, a 2 cm lateral longitudinal incision is made over the joint line, and the eight-plate is transfixed across the calcaneocuboid physis using two 3.5 mm cannulated screws to gradually restrict lateral column overgrowth and allow medial column alignment
lateral calcaneocuboid joint epiphysiodesis using a tension-band plate (eight-plate). Under fluoroscopic guidance, a 2 cm lateral longitudinal incision is made over the joint line, and the eight-plate is transfixed across the calcaneocuboid physis using two 3.5 mm cannulated screws to gradually restrict lateral column overgrowth and allow medial column alignment.
talo-first metatarsal angle (TM1A)
measuring talo-first metatarsal angle (TM1A) pre and post
Time frame: up to 24 months postoperatively (Final follow-up)
the calcaneo-fifth metatarsal angle (CM5A)
measuring angle the calcaneo-fifth metatarsal angle (CM5A)
Time frame: 24 month
the length of the medial and lateral column ratio
Time frame: 24 month
This study is completed, as verified in Oct 2023. You cannot join it, but the record below documents what was studied.
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Cairo University