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Ankle Joint

Ankle Joint

The ankle is formed by the talocrural joint (crural = leg). It consists of the articulations between the talus bone of the foot and the distal ends of the tibia and fibula of the leg. The superior aspect of the talus bone is square-shaped and has three areas of articulation. The top of the talus articulates with the inferior tibia. This is the portion of the ankle joint that carries the body weight between the leg and foot. The sides of the talus are firmly held in position by the articulations...

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Treatment of Ankle Osteoarthritis with Total Ankle Replacement Through a Lateral Transfibular Approach

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Talar-tarsal Stabilisation: Goals and Initial Outcomes.

Peter Stevens¹, Alex Lancaster¹, Ansab Khwaja²

¹Department of Orthopedics, University of Utah, Salt Lake City, Utah, United States of America.

Strategies in Trauma and Limb Reconstruction

|February 3, 2022

Summary

Talo-tarsal stabilization (TTS) in children with flexible planovalgus deformity is a simpler surgical option. This method effectively prevents the need for more invasive procedures like calcaneal lengthening.

Keywords:

Arthroeresis Flatfeet Planovalgus foot Subtalar instability

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Area of Science:

Orthopedic surgery
Pediatric orthopedics
Foot and ankle surgery

Background:

Surgical subtalar joint stabilization (arthroeresis) in children is debated in the USA but common globally.
Talo-tarsal stabilization (TTS) was chosen by parents over calcaneal lengthening for less invasive treatment.
The aim was to prevent or delay hindfoot osteotomy in pediatric flatfoot cases.

Purpose of the Study:

To evaluate the outcomes of talo-tarsal stabilization (TTS) in pediatric patients with flexible planovalgus deformity.
To assess the efficacy of TTS in avoiding more extensive surgical interventions.

Main Methods:

Retrospective review of 32 patients (60 ft) aged 6-15 years with flexible planovalgus deformity.
Minimum 1-year follow-up after TTS, with some patients undergoing concomitant procedures like Achilles lengthening.
Data collected on implant retention, patient outcomes, and need for subsequent surgery.

Main Results:

83.4% of implants were retained at follow-up (1-4.5 years), with satisfactory patient outcomes.
Complications included peroneal spasm in 6% of feet, managed non-operatively or with tendon transfer.
16.6% of implants required repositioning or removal, but these patients did not develop recurrent deformity or require further surgery.

Conclusions:

Talo-tarsal stabilization (TTS), when combined with indicated procedures, offers advantages over medial shift osteotomy or calcaneal lengthening.
TTS is a simpler and preferred surgical option for symptomatic flatfoot in children.
Successful TTS obviates the need for more invasive calcaneal osteotomy or lengthening procedures.