Talectomy in the treatment of the myelomeningocele patient.
This paper is an analysis of a series of 11 pediatric myelomeningocele patients in whom 20 talectomies were performed for correction of rigid equinovarus of paralytic vertical talus deformities. In most of the patients talectomy achieved a satisfactory correction of the foot deformity with maintenance of the correction for up to 5 years of follow-up in this study. Failure of the procedure related to two factors: (1) severe external rotational contracture of the hips in patients with high spinal lesions; (2) incomplete removal of the talus because of extensive scarring and fibrosis due to prior infection or surgery. Correction of the external rotational deformity of the hip or a derotational supramalleolar osteotomy of the tibia can prevent the first cause of failure. An intra-operative X-ray of the foot can prevent the latter.
D001176:Arthrogryposis / Q000209:etiology / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D003025:Clubfoot / Q000209:etiology / Q000601:surgery; D005260:Female; D005528:Foot / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008591:Meningomyelocele / Q000150:complications / Q000601:surgery*; D011859:Radiography; D016135:Spinal Dysraphism / Q000601:surgery*; D013628:Talus / Q000601:surgery*