We have located links that may give you full text access.
Minimally Invasive Method in Treatment of Idiopathic Congenital Vertical Talus: Recurrence is Uncommon.
Journal of Pediatric Orthopedics 2022 October 2
BACKGROUND: Historically, treatment for congenital vertical talus (CVT) has included open reduction of the talonavicular joint and extensive soft tissue release. In 2006, a new minimally invasive method consisting of serial manipulation and casting followed by percutaneous fixation of the talonavicular joint and percutaneous Achilles tenotomy was introduced. Although the early results of this new technique are promising, more research is needed to verify that the talonavicular correction is maintained with time.
METHODS: We conducted a retrospective chart review of all patients with idiopathic CVT who underwent minimally invasive correction by a single surgeon at a tertiary care institution. Radiographic evaluation of the preoperative, immediate postoperative, 1 year postoperative and latest follow-up appointments were performed. Complications and clinical outcomes were recorded. Radiographic recurrence of the deformity was defined as lateral talar axis-first metatarsal base angle >30 degrees. Statistical analysis was performed on the maintenance of radiographic correction and factors associated with recurrence.
RESULTS: Forty seven feet in 35 patients were included in the study with average follow-up of 45 months. The average preoperative lateral talar axis-first metatarsal base angle was 74±18 compared with 12±8 after initial surgical intervention. In addition, radiographic correction of all other measured angles was achieved in every child following the initial surgery. Radiographic recurrence of talonavicular deformity was seen in 4 feet (9%). No cases of recurrence required a second corrective surgery during the follow-up period. There was a significant association between patient age at the time of treatment and recurrence of talonavicular deformity with patients older than 12 months being more likely to experience recurrence ( P =0.041).
CONCLUSIONS: In this large series, we found that correction of talonavicular deformity can be achieved and maintained in a large majority of children with idiopathic CVT who undergo treatment with this minimally invasive technique and recurrences are uncommon. Treatment with this technique should be initiated as soon as a diagnosis of CVT is confirmed and the patient is medically stable to decrease the likelihood of experiencing recurrence of talonavicular deformity.
LEVEL OF EVIDENCE: Level III.
METHODS: We conducted a retrospective chart review of all patients with idiopathic CVT who underwent minimally invasive correction by a single surgeon at a tertiary care institution. Radiographic evaluation of the preoperative, immediate postoperative, 1 year postoperative and latest follow-up appointments were performed. Complications and clinical outcomes were recorded. Radiographic recurrence of the deformity was defined as lateral talar axis-first metatarsal base angle >30 degrees. Statistical analysis was performed on the maintenance of radiographic correction and factors associated with recurrence.
RESULTS: Forty seven feet in 35 patients were included in the study with average follow-up of 45 months. The average preoperative lateral talar axis-first metatarsal base angle was 74±18 compared with 12±8 after initial surgical intervention. In addition, radiographic correction of all other measured angles was achieved in every child following the initial surgery. Radiographic recurrence of talonavicular deformity was seen in 4 feet (9%). No cases of recurrence required a second corrective surgery during the follow-up period. There was a significant association between patient age at the time of treatment and recurrence of talonavicular deformity with patients older than 12 months being more likely to experience recurrence ( P =0.041).
CONCLUSIONS: In this large series, we found that correction of talonavicular deformity can be achieved and maintained in a large majority of children with idiopathic CVT who undergo treatment with this minimally invasive technique and recurrences are uncommon. Treatment with this technique should be initiated as soon as a diagnosis of CVT is confirmed and the patient is medically stable to decrease the likelihood of experiencing recurrence of talonavicular deformity.
LEVEL OF EVIDENCE: Level III.
Full text links
Related Resources
Trending Papers
The 'Ten Commandments' for the 2023 European Society of Cardiology guidelines for the management of endocarditis.European Heart Journal 2024 April 18
Challenges in Septic Shock: From New Hemodynamics to Blood Purification Therapies.Journal of Personalized Medicine 2024 Februrary 4
A Guide to the Use of Vasopressors and Inotropes for Patients in Shock.Journal of Intensive Care Medicine 2024 April 14
Prevention and treatment of ischaemic and haemorrhagic stroke in people with diabetes mellitus: a focus on glucose control and comorbidities.Diabetologia 2024 April 17
Diagnosis and Management of Cardiac Sarcoidosis: A Scientific Statement From the American Heart Association.Circulation 2024 April 19
Eosinophilic Esophagitis: Clinical Pearls for Primary Care Providers and Gastroenterologists.Mayo Clinic Proceedings 2024 April
Essential thrombocythaemia: A contemporary approach with new drugs on the horizon.British Journal of Haematology 2024 April 9
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app