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Talectomy as Part of Chronic Foot and Ankle Deformity Correction Procedure: A Retrospective Study

  • Travis Langan
    Correspondence
    Address correspondence to: Travis Langan, DPM, AACFAS, Podiatric Medicine and Surgery Residency Program, Department of Orthopaedics, 1400 Locust St, Building B Room 9520, University of Pittsburgh Medical Center, Pittsburgh, PA 15219.
    Affiliations
    Resident, Podiatric Medicine and Surgery Residency Program, Department of Orthopaedics, University of Pittsburgh Medical Center, Pittsburgh, PA
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  • Trapper A.J. Lalli
    Affiliations
    Assistant Professor, Department of Orthopaedic Surgery, University of Texas Southwestern Medical Center, Dallas, TX
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  • Clair N. Smith
    Affiliations
    Clinical Research Associate, Clinical Outcomes Research Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA
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  • Dane K. Wukich
    Affiliations
    Professor and Chairman, Department of Orthopaedic Surgery, University of Texas Southwestern Medical Center, Dallas, TX

    Professor, Department of Orthopaedic Surgery, University of Texas Southwestern School of Medicine, University of Texas Southwestern Medical Center, Dallas, TX
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Published:November 05, 2019DOI:https://doi.org/10.1053/j.jfas.2019.05.002

      ABSTRACT

      Severe foot and ankle deformities can be associated with high complication rates and impaired quality of life in patients. Surgical correction using a talectomy procedure has previously been described in many lower extremity pathologies and is a powerful tool for the correction of severe foot and ankle deformity. This study aimed to describe the role of talectomy and the outcomes of this procedure in patients presenting with severe foot and ankle deformity. A review of 45 patients undergoing talectomy by a single surgeon was completed. Data extracted included the cause of deformity, history of infection, body mass index, and relevant comorbidities. Outcome measures of interest were minor or major complications and limb functionality at final follow-up. Statistical analysis was performed by using a Wilcoxon rank sum test and a Fisher exact test looking at variables affecting selected outcome measures. Limb salvage occurred in 38 of 45 patients (84.4%). Patients with an infection history had 89% lower odds of a functional limb at final follow-up (p = .0389). Six of 7 patients (85.7%) who ultimately underwent amputation had a history of prior infection. Women had 8.25 times higher odds of having a functional limb compared with men (p = .047). All 13 patients with major complications had neuropathy (p = .024). Patients with chronic lower extremity deformities can successfully be treated with a talectomy as a part of the reconstructive procedure. This is a challenging patient population that is associated with a high complication rate. Patients with a history of infection should be counseled on the possibility of requiring major amputation.

      Level of Clinical Evidence

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