Dennyson-Fulford subtalar extra-articular arthrodesis in the treatment of paralytic pes planovalgus and its value in the alignment of the foot
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Acta Orthop Traumatol Turc 37 (2): 162--169 (2003)

OBJECTIVES: We evaluated the results of Dennyson-Fulford subtalar extra-articular arthrodesis performed in patients with paralytic planovalgus deformity and its success in realignment of the foot. METHODS: Dennyson-Fulford subtalar extra-articular arthrodesis was performed in 19 feet of 12 patients (5 girls, 7 boys; mean age 97.5 months; range 79-138 months) with paralytic planovalgus deformity. The underlying causes were poliomyelitis (n=5), cerebral palsy (n=5), and meningomyelocele (n=2). Seven patients had bilateral involvement; the remaining deformities were on the right in four patients, and on the left in one patient. Simultaneous operations were performed in six patients with bilateral deformity. The results were assessed both clinically and radiologically. The mean follow-up was 35.8 months (range 7 to 82 months). RESULTS: Union was achieved in all patients within sufficient degree and time. Clinical results were good in 10 feet (52\%), moderate in eight feet (42\%), and poor in one foot (6\%). Radiological results were good in five feet (26\%), moderate in 12 feet (64\%), and poor in two feet (10\%). None of the patients developed pseudoarthrosis or arthrosis of the neighboring joints. Sclerosis was observed around the screws in two patients, in one of whom sclerosis of more than 1 mm was associated with a poor clinical and radiologic outcome. CONCLUSION: Successful functional and radiologic results are obtained by Dennyson-Fulford subtalar extra-articular arthrodesis in the surgical treatment of paralytic planovalgus deformity in children with neuromuscular disorders.
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