Extra-articular subtalar fusion in children using the technique of locally raised interlocked bone-graft

ABSTRACT

Fourteen extra-articular suhtalar fusion procedures have been performed in eleven children with hindfoot valgus. Five children were boys and six were girls. Age ranged from 5-9 years with an average age of 6.5 years. The diagnosis was cerebral palsy in six feet, poliomyelitis in three feet, myelomeningocele in two feet, and neglected congenital convex pes valgus [congenital vertical talus] in three feet. Extra-articular suhtalar fusions were performed using local hone graft technique in all feet. Additional procedures included peroneus hrevis tendon transfer in five feet, tendoachillis lengthening in six feet, and peroneal tendons lengthening in nine feet. Open reduction of the talonavicular joint and K-wire fixation were performed in 4 feet. Follow-up averaged 34 months. Results were satisfactory in thirteen feet. Failure occurred in one case after nonunion of the graft with subsequent recurrence of the deformity. This was treated by Batchelor's suhtalar fusion. In another case graft resorption occurred after nine months but the hindfoot remained stable with no additional surgery required. Extra-articular suhtalar fusion using local hone graft technique as a part of surgical treatment of valgus deformities in children is a gentle, simple and reliable technique with minimal morbidity avoiding another operation for procuring an autogenous bone graft [iliac, fibular, or tibial]. Moreover, this technique proved to he successful in stabilization of the suhtalar joint in children