Triple arthrodesis in young children: a salvage procedure after failed releases in severely affected feet

A total of 19 triple arthrodeses were performed in 13 children aged 10 years or less for severe hindfoot deformities after failure of soft tissue releases. This was considered a salvage procedure and an alternative to talectomy. The average age at surgery was 8.4 years and average follow-up was 4 years. There were 68% excellent and good results, 16% fair, and 16% poor results. The nonunion rate was 7% of joints. Average shortening of the foot was 0.81 in but was not significant when compared with a group of clubfoot control patients. Except for one infection, fair and poor results were due to residual rather than recurrent deformity. Triple arthrodesis may be indicated in the young child for residual hindfoot deformity as an alternative to talectomy. The potential problems of increased nonunion, severe compromise of foot length, and recurrence of deformity were not observed in this series.