Older Clubfoot Without Osteotomy Treated with MAC External Fixator

This case describes the treatment of a 10 year old female with bilateral resistant clubfeet. She underwent bilateral posterior release three times but failed to respond to this treatment. The decision was made to treat with the Biomet (Warsaw, IN, USA) multiaxial correcting (MAC) external fixation system on each foot. The use of the MAC external fixator allows for the gradual correction of angular deformity and displacement in all three planes, including the correction of residual or secondary deformities that occur during lengthening. The fixator can correct lower extremity deformities, including clubfoot, and allows the possibility of anatomic alignment within normal radiographic limits. Correction can be accomplished through soft tissues if the joints are intact. Although the left foot was fixed with an osteotomy, our focus is on the right side, which was treated with no osteotomies and gradual correction with a two-level MAC system.