Results of primary talectomy for clubfoot in infants and toddlers with arthrogryposis multiplex congenita

Abstract

© 2015, Medical Association of Thailand. All right reserved. Background: Equinovarus deformity in arthrogryposis multiplex congenita patients is rigid and difficult to treat. Radical soft tissue operations yielded good results though recurrence of deformity was high. Talectomy is a bony procedure recommended as either a salvage procedure or a primary operation. Objective: To evaluate the results of primary talectomy in infant and toddler patients retrospectively. Material and Method: Arthrogryposis multiplex congenita patients with rigid equinovarus deformity treated with talectomy initially were retrospectively reviewed. Pain score, residual foot deformity, shoe modification, and ambulatory status were assessed. Results: Talectomy were performed in 19 arthrogrypotic feet in 10 infants and toddlers. There were 6 males and 4 females. The mean age at surgery was 1.3 years old and the mean age of the follow-up time was 4.9 years. All patients had plantigrade foot without pain. One arthrogrypotic foot required posteromedial release 2 years after index surgery due to recurrent deformity. Conclusion: Talectomy as the primary procedure in arthrogrypotic infants and toddlers demonstrated good results with few residual deformities and recurrence. Patients could achieve plantigrade position.