Talectomy for clubfoot in arthrogryposis

We reviewed the results of 101 talectomies in 56 patients with arthrogrypot ic clubfeet. The average age at the time of surgery was 4.3 years and the m ean follow-up was 6 years. Talectomy was performed as a primary procedure i n 16 feet and as a salvage procedure in 85 feet that underwent other surgic al procedures before talectomy. We graded our results as good when the foot was plantigrade, able to wear regular shoes, pain free, and, very importan t, patient satisfaction. We used a chi(2) statistical test and, after compa ring results with age <4 to >4 years at time of surgery, tendo Achilles ten otomy, time of casting, radiological complete excision of talus, and transc alcaneal pin placement, only the immobilization time needed to be statistic ally significant to achieve a good result. We conclude that feet must be in dividualized for treatment and that, after reduction of the calcaneus in th e mortise, a short leg cast must be placed for 8 weeks to maintain position and alignment.