Mid-term outcomes of talar neck trapezoidal osteotomy for correction of severe rigid neurologic equinovarus foot.

Background: Severe rigid neurologic equinovarus foot (NEVF) deformity, though rare, significantly limits transfers and orthotic use in pediatric patients with neurological disorders. Standard treatments like arthrodesis or talectomy are highly invasive, especially in young patients. This study assesses the mid-term outcomes of a talar neck trapezoidal osteotomy (TNTO) to correct severe NEVF in non-ambulatory patients.

Methods: A retrospective analysis included severe NEVF patients treated with TNTO and muscle rebalancing (2015-2019). Radiographic assessments evaluated alignment and avascular necrosis, while functional outcomes and caregiver satisfaction were recorded RESULTS: Nine patients (56 % male; median age 11, IQR: 9.2-11.2) with a median follow-up of 53.3 months (IQR: 42.4-80.1) showed significant improvements in alignment (p < 0.05) and function (p < 0.05). Caregiver satisfaction was high (100 %), with one patient experiencing asymptomatic partial avascular necrosis.

Conclusions: TNTO is a safe, effective option for correcting severe NEVF, achieving positive outcomes in foot alignment, orthotic use, and caregiver satisfaction mid-term.