Issue: July 2011
July 01, 2011
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Hindfoot fixation in flat feet for patients with neurological impairment viable with talonavicular arthrodesis

De Coulon G, et al. J Pediatr Orthop. 2011. doi: 10.1097/BPO.0b013e31821fffa0

Issue: July 2011
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Children with flat feet and neurological impairment who are in need of hindfoot fixation can be treated with talonavicular arthrodesis, according to a study from Swiss researchers.

“Talonavicular arthrodesis is a well-known technique in adult patients, but to our knowledge, it has not been described in children with neurological impairment,” the authors wrote.

The team performed a retrospective chart and radiographic review, investigating clinical findings from 18 neurological patients at their center with a mean age of 11.3 years. All patients underwent talonavicular arthrodesis to treat flat foot deformities between 1998 and 2009.

The results obtained with alonavicular arthrodesis were graded — with the Yoo clinical outcome scoring scale — as satisfactory, the team reported, in 28 feet from the 29-foot cohort. One was graded unsatisfactory. The team noted three feet from two patients were the cause of preoperative pain, with no pain after the final follow-up. Two of the 13 patients who used braces prior to surgery were able to stop using braces postoperatively, and the significant postoperative improvement seen in all patients through radiographic measurement angles was maintained free of any angle correction loss at final follow-up.