Abstract

The treatment concerning the talipes equinovarus has now a protocol that is well established. If the results at the age of one year are unsatisfactory, we may rely to surgical treatment. The type of surgical treatment depends upon the grade of deformation. Talectomy is a salvage procedure that has a useful place in the management of the severely deformed or rigid foot in some cases of arthrogryposis multiplex congenita, myelomeningocele or idiopathic talipes equinovarus in which the foot is rigid and deformed. We followed the results of the talectomy on the very severely deformed foot in 6 patients (9 feet): 1 case of congenital constriction band syndrome, 3 cases of arthrogryposis multiplex congenita, 1 case of muscular dystrophy, 2 cases of congenital longitudinal deficiency of the femur and 2 cases of neglected idiopathic clubfoot. These cases were treated in the Department of Pediatric Orthopedics of the Rehabilitation Clinic of Cluj-Napoca for a period ranging between 1998 and 2003. After the failure of classic surgical treatment these feet were corrected by talectomy; for the alignment of the foot we used only plasters of Paris that was maintained for a period of 2 months. In all the cases we achieved a good reduction of the deformity, with a pain-free foot and an acceptable range of motion in the ankle joint. MRI of the foot was done in selected cases (after 10 years) and it showed us the congruency between the calcaneus and the tibioperoneal mortise. All the feet whose deformation was corrected were also subjected to ortheses afterwards for a period of 2 years. For the evaluation of our results we have built a Microsoft Access database and the analysis have been performed with EPIINFO software. All images have been digitalized and stored for later follow-up comparisons.

Keywords

Talipes equinovarus, Talectomy, Bioinformatics.