Lateral Arthroereisis of the Subtalar Joint for the Treatment of Paralytic Pes Plano-Valgus.

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We studied 23 LeLièvre's operations (lateral arthroereisis of the subtalar joint using the bank bone) performed in 13 patients for the treatment of paralytic pes plano-valgus. 9 patients (15 feet) had the diagnosis of mild cerebral palsy and 4 patients (8 feet) had psycho-motor retardation. 11 patients (19 feet) had Vulpius' operation or Achilles tendon lengthening simultaneously. The average age at surgery was 6 years and 11 months (range, 3 to 13 years) and the average duration of follow-up was 8 years (range, 4 to 13 years). On the weight-bearing films, lateral tab-first metatarsal angle and lateral talo-calcaneal angle were measured to evaluate the postoperative results.The overall results were excellent in 7 feet, good in 6, fair in 2 and poor in 8. Using the metacarpal or metatarsal bone and combined procedure with vulpius' operation or Achilles tendon lengthening, the results were excellent in 7 feet, good in 4, fair in 2 and poor in none.This operation is to be indicated for i) paralytic pes plano-valgus which resists conservative treatments, ii) the patient who had psycho-motor retardation or mild cerebral palsy, and iii) the younger child who is 7-8 years old or less.
西日本整形・災害外科学会の論文