Talectomy in patients with recurrent deformity in club foot

Abstract

We reviewed 24 feet in 15 patients who had undergone talectomy for recurrent equinovarus deformity; 21 were associated with arthrogryposis multiplex congenita, two with myelomeningocele and one with idiopathic congenital talipes equinovarus. The mean follow-up was 20 years. Good results were achieved in eight feet (33%) in which further surgery was not needed and walking was painless; a fair result was obtained in ten feet (42%) in which further surgery for recurrence of a hindfoot deformity had been necessary but walking was painless; the remaining six feet (25%) were poor, with pain on walking. All patients wore normal shoes and could walk independently, except one who was wheelchair-bound because of other joint problems. Recurrent deformity, the development of tibiocalcaneal arthritis and spontaneous fusion of the tibia to the calcaneum were all seen in these patients.

Early Results of the Ponseti Method for the Treatment of Clubfoot Associated with Myelomeningocele

“…high rate of both short-term and long-term complications [36][37][38][39][40][41][42][43] . The justification for surgical management in this patient population is based on previous reports that have shown serial casting to be ineffective and complication-prone 25,28 .…”

Early Results of the Ponseti Method for the Treatment of Clubfoot in Distal Arthrogryposis

“…Common practice has been to treat clubfoot arising from complex etiologies such as distal arthrogryposis with extensive soft-tissuerelease surgery [10][11][12][13][14] or a talectomy [15][16][17] , an assumption based on the severe rigidity often associated with these conditions. The data from the current study, however, support the use of the Ponseti method for patients with distal arthrogryposis on the basis of the short-term success approaching that for idiopathic clubfoot.…”

“…Currently, ten different distal arthrogrypotic syndromes have been classified; all are characterized by hand and foot contractures, limited proximal involvement, and autosomal dominant inheritance 9 . The traditional treatment for clubfoot associated with these syndromes is either a radical soft-tissue release [10][11][12][13][14] or talectomy [15][16][17] , both of which have been associated with mixed results. A high rate of recurrence has been reported after radical soft-tissue release for the treatment of arthrogrypotic clubfoot [11][12][13]18 , with this recurrence leading to repeat soft-tissue releases or salvage procedures.…”

Astragalectomía. Evaluación funcional y radiográfica. Reporte de 5 casos. [Talectomy. Functional and radiographic evaluation. Report of 5 cases]

“…[1][2][3][4] La mayoría de las publicaciones comunican resultados satisfactorios en estas deformidades de los pies.…”

“…[1][2][3][4] En adultos, se utiliza como procedimiento de rescate para seudoartrosis de artrodesis de tobillo, fallas en las artroplastias de tobillo, osteonecrosis de astrágalo, artropatías inflamatorias, secuelas de pie bot, deformidades secundarias a lesiones del nervio ciático, síndrome compartimental y neuroartropatía. 1 no se recomienda como tratamiento primario en fracturas-luxaciones graves de astrágalo, porque genera efectos indeseables en el tobillo y el pie.…”