Talectomy for clubfoot in arthrogryposis

We reviewed the results of 101 talectomies in 56 patients with arthrogrypotic clubfeet. The average age at the time of surgery was 4.3 years and the mean follow-up was 6 years. Talectomy was performed as a primary procedure in 16 feet and as a salvage procedure in 85 feet that underwent other surgical procedures before talectomy. We graded our results as good when the foot was plantigrade, able to wear regular shoes, pain free, and, very important, patient satisfaction. We used a chi2 statistical test and, after comparing results with age <4 to >4 years at time of surgery, tendo Achilles tenotomy, time of casting, radiological complete excision of talus, and transcalcaneal pin placement, only the immobilization time needed to be statistically significant to achieve a good result. We conclude that feet must be individualized for treatment and that, after reduction of the calcaneus in the mortise, a short leg cast must be placed for 8 weeks to maintain position and alignment.