Triple tarsal arthrodesis in the treatment of spastic foot in cerebral palsy.

Background. This article presents an evaluation of triple arthrodesis performed on patients with cerebral palsy. The indication for surgery was significant foot deformity causing disturbances in gait. Material and methods. From 1982 to 2000, triple arthrodesis was performed on 34 patients (16 boys, 18 girls, average age 16,5) with cerebral palsy. The most common form of CP was diparegia, 20 patients were operated unilaterally, 14 patients bilaterally; 48 operations were performed altogether (14 equino-varus feet and 34 planovalgus feet with adduction of the forefoot). The triple arthrodesis was joined with an elongation of the Achilles tendon, the posterior tendon of the tibial muscle, and the flexor digitorum and longus muscles. Follow-up was 6 years on the average (1-9 years). Results and conclusions. The results indicate that triple arthrodesis is a satisfactory method of spastic foot treatment with robust outcome in patients with cerebral palsy (able to walk). It is demonstrated that equinovarus deformity allows for better correction than planovalgus deformity.