Single Stage Surgery for Treatment of Congenital Vertical Talus in Children 1 – 4 Years old
Iraqi Postgraduate Medical Journal,
2012, Volume 11, Issue 0, Pages 658-667
AbstractABSTRACT: BACKGROUND: Congenital vertical talus is an uncommon foot deformity that is present at birth and results in a rigid flatfoot deformity if left untreated and is more commonly associated with other neuromuscular conditions which have more rigid deformity and less favorable outcome. OBJECTIVE: To find the extent of radiological and clinical improvements after using a single stage surgical treatment for children aged 1 to 4 years having congenital vertical talus. METHOD: Single stage surgery was performed on 15 patients (19 feet) with congenital vertical talus starting from October 2008 to September 2010; all the patients were evaluated clinically and radiologicaly by measuring talocalcaneal and tibiocalcaneal angles, and categorized into 2 age groups for sake of treatment selection. Patients younger than 2 years were treated by soft tissue release, tendon lengthening and k-wire fixation of talonavicular joint, while in patients aged 2 years to 3 years and 6 months of age we added a tibialis anterior transfer to the surgery. Postoperatively the cases were evaluated in a way similar to that used prior to surgery. Analytic studies were performed, comparing the postoperative scores to those scores prior to surgery. RESULTS: Clinical improvements by increasing of the mean of clinical score from (12.79) preoperatively to (18.50) on last follow up evaluation and radiological improvements after single stage surgery showed by highly significant decrease in mean of lateral talocalcaneal angles with difference of (14.53°) and the highly significant decrease in mean of lateral tibiocalcaneal angles with difference of (35.06°). CONCLUSION: Single stage surgical treatment is very useful for treatment of congenital vertical talus in children 1 – 4 years old and can help to avoid the need for two-stage surgical correction and excisional surgeries.
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