Fibular-Achilles tenodesis for paralytic ankle valgus

Children with myelomeningocele often develop progressive valgus deformity of the ankle that may be concomitant with, or mistaken for, paralytic hindfoot valgus. The same deformity is encountered in children who sustain lower motor neuron deficits. It is imperative to obtain an anteroposterior weight-bearing radiograph of the ankles to differentiate and document the degree of ankle valgus. To address the ankle deformity, we employed the fibular-Achilles tenodesis described by Westin. We are reporting our experience with 18 patients (32 ankles) who underwent this procedure. We noted improvement in relative fibular length and reduced talar tilt in 26 ankles (81.2%). In addition, there was some improvement in the orientation of the hindfoot; rotational deformity was unaffected.