Journals / Acta Orthopaedica et Traumatologica Turcica / 2015 / Cilt: 49 - Sayı: 2

Medium-term results of single-stage posteromedial release and triple arthrodesis in treatment of neglected clubfoot deformity in adults

Pages
175–183
DOI
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AI Summary & Key Takeaways

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⚡ TL;DR(Too Long; Didn't Read)

Nine patients developed degenerative changes in different joints and of different degrees.Conclusion: The authors believe that massive soft tissue release and triple arthrodesis performed in a single session yields satisfactory results cosmetically and functionally in neglected clubfoot cases with severe deformities

📌 3 Key Takeaways

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Objective & Hypothesis:Objective: This study aimed to evaluate the implementation, in a single session, of both massive posteromedial release and triple arthrodesis for rigid neglected clubfoot deformities in adult patients, and its effects on clinical and radiological results.Methods: The procedures were performed in one session on 15 feet of 11 patients [7 male, 4 female; mean age 26 (range: 15 to 50)].
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Key Findings & Data:Anteroposterior/lateral side talocalcaneal and talus-1st metatarsal angles were used as radiographic parameters.
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Conclusion & Impact:Nine patients developed degenerative changes in different joints and of different degrees.Conclusion: The authors believe that massive soft tissue release and triple arthrodesis performed in a single session yields satisfactory results cosmetically and functionally in neglected clubfoot cases with severe deformities
🔬Design:Research Article
📍Scope:Comprehensive Sample
⚙️Variables:Domain Parameters

Abstract

Objective: This study aimed to evaluate the implementation, in a single session, of both massive posteromedial release and triple arthrodesis for rigid neglected clubfoot deformities in adult patients, and its effects on clinical and radiological results.Methods: The procedures were performed in one session on 15 feet of 11 patients [7 male, 4 female; mean age 26 (range: 15 to 50)]. Staples were used for fixation in all patients. For clinical assessment, the AOFAS (American Orthopaedic Foot and Ankle Society) ankle- hindfoot scale was used. Anteroposterior/lateral side talocalcaneal and talus-1st metatarsal angles were used as radiographic parameters. The mean follow-up was 7.5 years (range: 6 to 11).Results: The mean AOFAS score rose from a preoperative 39 (range: 15 to 52) to 88 (range: 76 to 94) in the final follow up (p<0.0001). Among the 15 feet, 9 were evaluated as excellent, 5 as good, and 1 as fair. Significant clinical improvement was obtained between preoperative and postoperative surgical periods (p<0.05). Significant improvements were observed in radiographic parameters (p<0.0001). At final follow-up, radiographic values were within normal physiological limits. Average union time was 12.4 (range: 7 to 36) weeks. While pseudoarthrosis was not observed in any patients, delayed union developed in 2 cases, and talus avascular necrosis in 1. In the preoperative period, 5 patients had various degrees of degenerative changes. Nine patients developed degenerative changes in different joints and of different degrees.Conclusion: The authors believe that massive soft tissue release and triple arthrodesis performed in a single session yields satisfactory results cosmetically and functionally in neglected clubfoot cases with severe deformities

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Cite This Article

AKINCI, O., AKALIN, Y. (2015). Medium-term results of single-stage posteromedial release and triple arthrodesis in treatment of neglected clubfoot deformity in adults. Acta Orthopaedica et Traumatologica Turcica, Cilt: 49 - Sayı: 2, 175–183. https://ajindex.com/articles/354083

References (7)

  1. Nordin S, Aidura M, Razak S, Faisham W. Controversies in congenital clubfoot: literature review. Malays J Med Sci 2002;9:34-40.
  2. Saltzman CL, Fehrle MJ, Cooper RR, Spencer EC, Ponseti IV. Triple arthrodesis: twenty-five and forty-four-year av- erage follow-up of the same patients. J Bone Joint Surg Am 1999;81:1391-402.
  3. Cummings RJ, Lovell WW. Operative treatment of congenital idiopathic club foot. J Bone Joint Surg Am 1988;70:1108-12. Penny JN. The neglected clubfoot. Techniques in ortho- paedics 2005;20:153-66.
  4. Ramseier LE, Schoeniger R, Vienne P, Espinosa N. Treat- ment of late recurring idiopathic clubfoot deformity in adults. Acta Orthop Belg 2007;73:641-7. de Heus JA, Marti RK, Besselaar PP, Albers GH. The in- fluence of subtalar and triple arthrodesis on the tibiotalar joint. A long-term follow-up study. J Bone Joint Surg Br 1997;79:644-7.
  5. Vanderwilde R, Staheli LT, Chew DE, Malagon V. Mea- surements on radiographs of the foot in normal infants and children. J Bone Joint Surg Am 1988;70:407-15. Mäenpää H, Lehto MU, Belt EA. What went wrong in tri- ple arthrodesis? An analysis of failures in 21 patients. Clin Orthop Relat Res 2001;391:218-23. de Groot IB, Reijman M, Luning HA, Verhaar JA. Long-term results after a triple arthrodesis of the hind- foot: function and satisfaction in 36 patients. Int Orthop 2008;32:237-41. Turco VJ. Surgical correction of the resistant club foot. One-stage posteromedial release with internal fixation: a preliminary report. J Bone Joint Surg Am 1971;53:477- 97. Kitaoka HB, Alexander IJ, Adelaar RS, Nunley JA, Myer- son MS, Sanders M. Clinical rating systems for the ankle- hindfoot, midfoot, hallux, and lesser toes. Foot Ankle Int 1994;15:349-53.
  6. Herold HZ, Torok G. Surgical correction of neglected club foot in the older child and adult. J Bone Joint Surg Am 1973;55:1385-95. van Dijk CN, Lim LS, Poortman A, Strübbe EH, Marti RK. Degenerative joint disease in female ballet dancers. Am J Sports Med 1995;23:295-300. Evans D. Relapsed club foot. J Bone Joint Surg 1961;43- B:722-33. Abrams RC. Relapsed club foot. The early results of an evaluation of Dillwyn Evans' operation. J Bone Joint Surg Am 1969;51:270-82. Lichtblau S. A medial and lateral release operation for club foot. A preliminary report. J Bone Joint Surg Am 1973;55:1377-84.
  7. Toohey JS, Campbell P. Distal calcaneal osteotomy in resistant talipes equinovarus. Clin Orthop Relat Res 1985;197:224-30. Dwyer FC. The treatment of relapsed club foot by the in- sertion of a we