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Equinus Deformity
Published in Benjamin Joseph, Selvadurai Nayagam, Randall T Loder, Anjali Benjamin Daniel, Essential Paediatric Orthopaedic Decision Making, 2022
Christopher Prior, Nicholas Peterson, Selvadurai Nayagam
Correction of equinus Serial manipulation and castingSofttissue procedures Revision of Achilles tendon lengtheningPosterior ankle releasePlantar fascia releaseGradual correction of ankle equinus With a circular external fixator with or without foot osteotomiesAnterior distal tibial hemiepiphyseodesisArthrodesis Triple arthrodesis (Lambrinudi)Ankle arthrodesis
Paediatric and adolescent foot disorders
Published in Maneesh Bhatia, Essentials of Foot and Ankle Surgery, 2021
Arthrodesis is reserved as a salvage procedure for failed primary resections, multiple coalitions or associated degenerative disease and correction of the hindfoot valgus should be attained. In skeletally immature children, extra-articular arthrodesis, like the Grice procedure or any of its modifications, is preferred to avoid potential growth disturbances of the hindfoot. Triple arthrodesis should be exploited as a last resort, especially in young patients, given the well-documented long-term poor outcomes (113, 181–187).
Paediatric Orthopaedic Surgery
Published in Timothy W R Briggs, Jonathan Miles, William Aston, Heledd Havard, Daud TS Chou, Operative Orthopaedics, 2020
Jonathan Wright, Russell Hawkins, Aresh Hashemi-Nejad, Peter Calder
Various foot and ankle deformities are seen in cerebral palsy such as planovalgus, equinovalgus, equinovarus and calcaneovalgus. Triple arthrodesis is indicated for symptomatic degeneration and uncontrolled deformity. Despite frequent complications such as residual deformity, pseudarthrosis, pain and progressive intertarsal and tarsometatarsal arthritis, the response to surgery is good.
Arthroscopic triple arthrodesis for the patient with rheumatoid arthritis; a case report
Published in Modern Rheumatology Case Reports, 2021
Tomoyuki Nakasa, Yasunari Ikuta, Munekazu Kanemitsu, Nobuo Adachi
A 60 year-old-male with a 6 year – history of RA had been treated with 10 mg/week of methotrexate (Steinbrocker functional class 2, radiographic stage 3). He had the history of the administration of corticosteroid 5 mg daily for 3 years. He had suffered from pain in the left foot, right hip joint, and bilateral knee joint. Since the destruction of his right hip joint progressed, total hip arthroplasty was performed. In spite of systemic drug therapy, the pain and deformity of his left foot had proceeded. His left foot was swollen with local heat at the dorsal aspect, exhibiting pes planovalgus deformity. The pes planovalgus was flexible to be manually corrected. Severe tenderness of the talonavicular joint was observed. On plain radiograms, the talonavicular and calcaneocuboid joint space had disappeared, and the subtalar joint revealed joint space narrowing, classified as Larsen grade 4 (Figure 1). A CT scan showed disappearance of joint space with bone erosion of the talonavicular and calcaneocuboid joints, and joint space narrowing with subchondral sclerosis was observed at the subtalar joint. The Japanese Society for Surgery of the Foot (JSSF) RA foot and ankle scale was 38 points. Our patient was prescribed orthotics and crutches, but his symptoms gradually worsened. Therefore, we performed triple arthrodesis to ameliorate his foot pain and correct his foot alignment. Taking into consideration his skin condition due to the history of the taking the corticosteroids and methotrexate and bone quality due to RA, less invasive surgery using arthroscopy was chosen.
Management of a patient’s gait abnormality using smartphone technology in-clinic for improved qualitative analysis: A case report
Published in Physiotherapy Theory and Practice, 2018
William R. VanWye, Donald L. Hoover
The triple arthrodesis is performed to simultaneously fuse the joints of the hind foot (talonavicular, talocalcaneal, and calcaneocuboid joints) (D’Angelantonio, Schick, Arjomandi, 2012). It has been labeled as a salvage procedure to address hind foot pain and instability associated with severe joint degeneration or, as in this case, a post-traumatic condition (D’Angelantonio, Schick, Arjomandi, 2012). Immediate complications of this procedure are symptomatic non-union resulting in re-operation, superficial wounds, infection, pulmonary emboli, and dystrophy (Ib, Reijman, Ha, Ja, 2008). Long-term complications, beyond the biomechanical changes due to fusion of the hind foot, include diminished talocrural joint ROM, increased stress at distal and proximal joints, as well as reduced ankle joint power during gait (Beischer, Brodsky, Pollo, and Peereboom, 1999; D’Angelantonio, Schick, Arjomandi, 2012). The patient displayed gait dysfunction consistent with the characteristics reported in the medical literature. Therefore, it was concluded that these deficits would limit his ability to participate in a work-conditioning program, which is a rigorous program, requiring a therapeutic exercise dosage high enough to improve cardiorespiratory, neuromuscular, and musculoskeletal functions for return to work on a full-time basis.