Talectomy yielded good clinical outcomes in pediatric patients with clubfoot deformity

Source / Disclosures Published by:

Source:

Larson JE, et al. Paper 34. Presented at: Pediatric Orthopedic Society of North America Annual Meeting; May 12-15, 2021; Dallas (hybrid gathering).

Disclosures:
Larson does not report relevant financial information.

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Results presented at the annual meeting of the Pediatric Orthopedic Society of North America showed that talectomy for the treatment of clubfoot deformity produced good clinical results, with correction maintained into adulthood.

Jill E. Larson, MD, and colleagues performed a retrospective review of data from all patients with non-idiopathic clubfoot deformity who underwent talectomy from 1975 to 2010. Of the 625 patients identified with clubfoot deformity, researchers noted 53 feet who underwent talectomy.

Of the 31 feet who met the full follow-up and inclusion criteria, the results showed that 18 patients had spina bifida and 13 patients had arthrogryposis.

Jill E. Larson

“A total of 17 feet were recorded with recurrent malformation. Of these, 11 had residual adduction or supination in the forefoot, ”said Larson in her presentation. “However, only three of these feet had a bad result at the last follow-up and only two feet required further surgery to achieve a ‘good’ result.”

Patients with residual or recurrent clubfoot deformity had a worse prognosis at last follow-up, and all patients reported a poor outcome, Larson said.

At the latest follow-up, Larson noted that talectomy had an overall success rate of 77.4%, with patients who underwent talectomy before the age of 5 had favorable outcomes. She added that a diagnosis of spina bifida or arthrogryposis did not affect recurrence, the need for further surgery, or the final outcome at the last visit.

Ambulatory status, as defined by a 3-1-1 on the functional mobility scale, resulted in a 2.7 times lower odds ratio of deformity recurrence and 2.4 times increased odds ratio of a good result at last follow-up , ”said Larson.

She also noted that patients had fewer total surgeries per foot when talectomy was performed as the primary corrective surgery compared to patients who underwent salvaged talectomy.

“A medium- and long-term subgroup analysis found no statistically significant difference between those patients who had a follow-up of 5 to 15 years or those with a follow-up of more than 15 years,” said Larson.

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