Subtalar joint arthrodesis for postpoliomyelitis valgus foot deformity

Area of Science:

• Orthopedic Surgery
• Reconstructive Surgery
• Foot and Ankle Surgery

Background:

• Pes planovalgus foot deformity is a common complication of residual polio myelitis.
• This deformity often results from invertor muscle paralysis, leading to significant functional impairment.
• Subtalar joint arthrodesis is a surgical option to correct severe foot deformities.

Purpose of the Study:

• To compare the outcomes of full versus partial subperiosteal fibular bone grafts for subtalar joint arthrodesis.
• To evaluate the efficacy and safety of different fibular graft types in patients with post-polio foot deformities.
• To assess the biomechanical sequelae associated with each graft type.

Main Methods:

• A prospective study involving 16 patients with postpoliomyelitis valgus foot deformity.
• All patients underwent peroneal tendon transfer and subtalar extra-articular arthrodesis.
• 12 patients received partial subperiosteal fibular grafts, and 4 received full fibular grafts.

Main Results:

• Partial fibular grafts (n=12) were not associated with major ankle or foot biomechanical issues.
• Full fibula grafts (n=4) resulted in adverse sequelae in 75% of cases.
• Axer's criteria were used for patient assessment over an average 2.5-year follow-up.

Conclusions:

• Partial subperiosteal fibular bone grafts are a safer alternative for subtalar joint arthrodesis in this patient population.
• Full fibula grafts carry a high risk of adverse biomechanical complications.
• This study highlights the importance of graft selection in managing complex foot deformities post-polio.