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Long-term follow-up of triple arthrodesis
Insights
Triple arthrodesis surgery in children yields excellent functional outcomes, particularly for conditions like poliomyelitis. Heel position and surgical technique, such as using staples, significantly influence long-term results and complication rates.
Area of Science:
- Orthopedic Surgery
- Pediatric Orthopedics
- Foot and Ankle Surgery
Background:
- Triple arthrodesis is a surgical procedure to fuse the three joints of the hindfoot.
- Long-term outcomes of triple arthrodesis in pediatric populations require further investigation.
- Understanding factors influencing success is crucial for optimizing patient care.
Purpose of the Study:
- To evaluate the long-term functional results of triple arthrodesis in children.
- To identify patient-related and surgical factors affecting outcomes.
- To assess the incidence of complications such as osteoarthritis and pseudarthrosis.
Main Methods:
- A retrospective review of 46 triple arthrodeses performed on 37 children.
- Follow-up duration ranged from 19 to 33 years (average 24 years).
- Assessment of functional outcomes, gait, and radiographic evidence of complications.
Main Results:
- 91% of patients achieved good or excellent functional results.
- Better outcomes were observed in cases of poliomyelitis, pes cavus, or pes planus compared to clubfoot, cerebral palsy, or spina bifida.
- Staple use appeared to improve results; neutral heel position was desirable, with varus positions requiring revision.
- Heel-toe gait was present in 74%; osteoarthritis occurred in 24%, and pseudarthrosis in 4%.
Conclusions:
- Triple arthrodesis provides favorable long-term functional outcomes in pediatric patients.
- Etiology of foot deformity and surgical technique (staples, heel position) are key determinants of success.
- Careful patient selection and surgical technique can minimize long-term complications.
Abstract:
Thirty-seven children in whom 46 triple arthrodeses had been performed were followed up for 19 to 33 years (average, 24 years). Better results were evident in patients who had been operated on because of poliomyelitis, pes cavus or pes planus than in patients operated on for club foot, cerebral palsy or spina bifida. The use of staples appeared to improve the result. A neutral position of the heel is desirable. Varus positions required revision in three patients. A heel-toe gait was noticeable in 74% of patients. Osteoarthritis occurred 24% and pseudarthrosis in 4% of our patients. In 91% of patients the functional result could be described as good or excellent.