Subtalar Extra-Articular Fusion in the Treatment of Valgus and Varus Deformities in Children: A Review of 162 Operations in 136 Patients
Acta Orthop Scand. 1972;43(5):438-460
Lahdenranta U, Pylkkänen P
The subtalar extra-articular fusions performed at the Orthopaedic Hospital of the Invalid Foundation from 1956 to 1969 were reviewed. One hundred forty-one ankles were operated on for poliomyelitis and 21 for other diseases. Valgus deformity was the cause of 134 and varus deformity of 28 operations. The original technique described by Grice was always used to correct the valgus deformity. Varus deformity was corrected by using a modification developed by A. Langenskiold, in addition to the usual method.
The patients’ ages ranged from 3 to 16 years: only 9 children were 11 or older. The follow-up periods ranged from just under a year to 12 years, average 9 years. At the time of the follow-up nearly two-thirds of the treated ankles were completely or almost completely full-grown. The early results, which became manifest during the first six months, and the late results differed considerably. The late follow-up examination
did show considerably more poor results than the early follow-up examination. In valgus ankles the poor late results were mainly due to the gradual development of overcorrection with concomitant varus deformity. For the varus ankles the early results usually were good, but in most cases the varus deformity returned in the course of time. Tendon transfers were carried out intraoperatively. From the present material it seems that transfer of both peroneal tendons to the calcaneus is not nearly so risky for the position of the ankles as their transfer to the dorsum pedis. If the transfer is to the dorsum pedis, only one of the peroneal tendons should be transferred, to avoid overcorrection. (Reprinted by permission of Taylor & Francis Ltd., http://www.tandf.co.uk/journals.)
Original Text by Clifford R. Wheeless, III, MD.
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