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The results of Grice Green subtalar arthrodesis of valgus foot in spina bifida.

Küçükdurmaz F, Ağır I, Saygı B, Bezer M - Indian J Orthop (2012)

Bottom Line: Mean preoperative talocalcaneal and calcaneal pitch angles were 48.5° and 31.9°, respectively, which decreased to 38.5° and 29.1°, respectively, postoperatively.The decrease in talocalcaneal angle and calcaneal pitch was significant between preoperative and postoperative measurements (P<0.05).In this study, we found more encouraging results in older patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedics and Traumatology, Bezmi Alem Vakif University School of Medicine, Üsküdar, Turkey.

ABSTRACT

Background: Valgus foot is a common foot deformity in spina bifida. The most popular operation for the valgus deformity has been the Grice talocalcaneal blocking. It has not been studied primarily in children with spina bifida. We report a prospective series, we present the results of hind foot valgus deformity of children with spina bifida, using Grice talocalcaneal arthrodesis with a tricortical iliac bone graft.

Materials and methods: Between May 2000 and December 2003, 21 patients with bilateral (42 feet) valgus deformity of feet underwent surgery. There were 7 males and 14 females. The mean age of patients was 67.7 months (range 50-108 months).

Results: The total number of feet that had nonunion was 11, in 7 of them the grafts were completely reabsorbed and the outcome of all these feet was unsatisfactory. Four feet had partial union of which three had unsatisfactory and one had satisfactory outcome. Sixteen feet had residual valgus deformity at the last followup visit, 10 patients had nonunion, and 6 had inadequate correction. Mean preoperative talocalcaneal and calcaneal pitch angles were 48.5° and 31.9°, respectively, which decreased to 38.5° and 29.1°, respectively, postoperatively. The decrease in talocalcaneal angle and calcaneal pitch was significant between preoperative and postoperative measurements (P<0.05).

Conclusion: Grice subtalar arthrodesis technique is still a valuable option for valgus foot in patients with spina bifida. In this study, we found more encouraging results in older patients.

No MeSH data available.


Related in: MedlinePlus

Clinical photograph showing valgus foot (Rt side) when the patient was weight bearing
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Figure 1: Clinical photograph showing valgus foot (Rt side) when the patient was weight bearing

Mentions: Between May 2000 and December 2003, 42 feet (21 patients) with valgus deformity underwent surgery. There were 7 male and 14 female patients with a mean age of 67.7 months (range 50–108 months). The mean followup period was 45 months (range 32–54 months). All patients had diagnosis of spina bifida with different levels of involvement. The low lumbar and the sacral segments were the most commonly involved regions. The spina bifida lesion was at mid-lumbar region (n=5) and at low lumbar and sacral regions (n=16). All of them were community ambulators. The valgus foot in patients was diagnosed at routine screening in spina bifida outpatient clinic in our center. Clinical and radiological diagnoses were combined for definitive diagnosis. The clinical diagnosis of valgus foot was made if there was valgus heel on inspection when they were standing [Figure 1] and if the medial head of talus was prominent on palpation.


The results of Grice Green subtalar arthrodesis of valgus foot in spina bifida.

Küçükdurmaz F, Ağır I, Saygı B, Bezer M - Indian J Orthop (2012)

Clinical photograph showing valgus foot (Rt side) when the patient was weight bearing
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3377146&req=5

Figure 1: Clinical photograph showing valgus foot (Rt side) when the patient was weight bearing
Mentions: Between May 2000 and December 2003, 42 feet (21 patients) with valgus deformity underwent surgery. There were 7 male and 14 female patients with a mean age of 67.7 months (range 50–108 months). The mean followup period was 45 months (range 32–54 months). All patients had diagnosis of spina bifida with different levels of involvement. The low lumbar and the sacral segments were the most commonly involved regions. The spina bifida lesion was at mid-lumbar region (n=5) and at low lumbar and sacral regions (n=16). All of them were community ambulators. The valgus foot in patients was diagnosed at routine screening in spina bifida outpatient clinic in our center. Clinical and radiological diagnoses were combined for definitive diagnosis. The clinical diagnosis of valgus foot was made if there was valgus heel on inspection when they were standing [Figure 1] and if the medial head of talus was prominent on palpation.

Bottom Line: Mean preoperative talocalcaneal and calcaneal pitch angles were 48.5° and 31.9°, respectively, which decreased to 38.5° and 29.1°, respectively, postoperatively.The decrease in talocalcaneal angle and calcaneal pitch was significant between preoperative and postoperative measurements (P<0.05).In this study, we found more encouraging results in older patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedics and Traumatology, Bezmi Alem Vakif University School of Medicine, Üsküdar, Turkey.

ABSTRACT

Background: Valgus foot is a common foot deformity in spina bifida. The most popular operation for the valgus deformity has been the Grice talocalcaneal blocking. It has not been studied primarily in children with spina bifida. We report a prospective series, we present the results of hind foot valgus deformity of children with spina bifida, using Grice talocalcaneal arthrodesis with a tricortical iliac bone graft.

Materials and methods: Between May 2000 and December 2003, 21 patients with bilateral (42 feet) valgus deformity of feet underwent surgery. There were 7 males and 14 females. The mean age of patients was 67.7 months (range 50-108 months).

Results: The total number of feet that had nonunion was 11, in 7 of them the grafts were completely reabsorbed and the outcome of all these feet was unsatisfactory. Four feet had partial union of which three had unsatisfactory and one had satisfactory outcome. Sixteen feet had residual valgus deformity at the last followup visit, 10 patients had nonunion, and 6 had inadequate correction. Mean preoperative talocalcaneal and calcaneal pitch angles were 48.5° and 31.9°, respectively, which decreased to 38.5° and 29.1°, respectively, postoperatively. The decrease in talocalcaneal angle and calcaneal pitch was significant between preoperative and postoperative measurements (P<0.05).

Conclusion: Grice subtalar arthrodesis technique is still a valuable option for valgus foot in patients with spina bifida. In this study, we found more encouraging results in older patients.

No MeSH data available.


Related in: MedlinePlus