149 – MANAGEMENT OF THE NEGLECTED CLUB FOOT IN THE OLDER CHILD WITH THE TAYLOR SPATIAL FRAME

Abstract

Purpose: To assess the efficacy of the Taylor Spatial Frame in the correction of rigid long standing foot deformities in older children.

Method: Children presenting with rigid longstanding foot deformities were fitted with a Taylor Spatial Frame (TSF) utilizing specialized small foot rings. Prior to surgery an operative plan was devised including soft tissue release and osteotomies usually consisting of a curved midfoot osteotomy and a dome shaped hind foot osteotomy. About 30% correction was obtained at surgery and held with the TSF. Postoperatively a computerized program of correction over a period of 8 weeks was calculated for each foot beginning 5 days after surgery and including an initial lengthening at each osteotomy site of 1 cm.

Results: A total of eight feet have been corrected utilizing this technique with the TSF. All feet have been successfully returned to a plantigrade position enabling the child to don normal footwear. Ankle-foot orthosis are utilized for one year following surgery. Although the feet are stiff none are painful and all children arev fully ambulatory and weight bearing. All have at least 10 degrees of ankle motion which is improving with time. Families have been very pleased with the improved anatomical appearance of the feet as well as the child’s ability to use normal footwear.

Conclusion: The Taylor Spatial Frame is an efficient and safe method to effect excellent correction of a rigid club foot deformity in combination with osteotomies and soft tissue releases of the foot.