Mid-term outcomes of talar neck trapezoidal osteotomy for correction of severe rigid neurologic equinovarus foot

IF 2 3区医学 Q2 ORTHOPEDICS Foot and Ankle Surgery Pub Date : 2025-01-04 DOI:10.1016/j.fas.2025.01.001

Jaime Garcia-Fernández , María Galán-Olleros , Manuel Fraga-Collarte, Ana Ramírez-Barragán, Carmen Martínez-González, Ignacio Martínez-Caballero

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Abstract

Background

Severe rigid neurologic equinovarus foot (NEVF) deformity, though rare, significantly limits transfers and orthotic use in pediatric patients with neurological disorders. Standard treatments like arthrodesis or talectomy are highly invasive, especially in young patients. This study assesses the mid-term outcomes of a talar neck trapezoidal osteotomy (TNTO) to correct severe NEVF in non-ambulatory patients.

Methods

A retrospective analysis included severe NEVF patients treated with TNTO and muscle rebalancing (2015–2019). Radiographic assessments evaluated alignment and avascular necrosis, while functional outcomes and caregiver satisfaction were recorded

Results

Nine patients (56 % male; median age 11, IQR: 9.2–11.2) with a median follow-up of 53.3 months (IQR: 42.4–80.1) showed significant improvements in alignment (p < 0.05) and function (p < 0.05). Caregiver satisfaction was high (100 %), with one patient experiencing asymptomatic partial avascular necrosis.

Conclusions

TNTO is a safe, effective option for correcting severe NEVF, achieving positive outcomes in foot alignment, orthotic use, and caregiver satisfaction mid-term.

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距颈梯形截骨术治疗重度神经性马蹄内翻足的中期疗效。

背景：严重的刚性神经性马内翻足（NEVF）畸形虽然罕见，但严重限制了神经系统疾病患儿的转移和矫形器的使用。标准治疗如关节融合术或talectomy是高度侵入性的，尤其是对年轻患者。本研究评估了距颈梯形截骨术（TNTO）矫正非卧床患者严重nef的中期结果。方法：回顾性分析2015-2019年接受TNTO和肌肉再平衡治疗的严重nef患者。x线评估评估对齐和无血管坏死，同时记录功能结局和护理人员满意度。结果：9例患者(56% %男性；中位年龄11岁，IQR: 9.2-11.2)，中位随访53.3个月（IQR: 42.4-80.1），结果显示患者在矫形方面有显著改善(p 结论：TNTO是一种安全、有效的矫正严重nef的选择，在足部矫形、矫形器使用和护理人员满意度方面取得了积极的中期结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Foot and Ankle Surgery ORTHOPEDICS-

CiteScore

4.60

自引率

16.00%

发文量

202

期刊介绍： Foot and Ankle Surgery is essential reading for everyone interested in the foot and ankle and its disorders. The approach is broad and includes all aspects of the subject from basic science to clinical management. Problems of both children and adults are included, as is trauma and chronic disease. Foot and Ankle Surgery is the official journal of European Foot and Ankle Society. The aims of this journal are to promote the art and science of ankle and foot surgery, to publish peer-reviewed research articles, to provide regular reviews by acknowledged experts on common problems, and to provide a forum for discussion with letters to the Editors. Reviews of books are also published. Papers are invited for possible publication in Foot and Ankle Surgery on the understanding that the material has not been published elsewhere or accepted for publication in another journal and does not infringe prior copyright.