Introduction

In 1927, Lambrinudi described a variant triple fusion for the treatment of paralytic “drop foot”. This involved closing wedge osteotomies and fusion to correct the deformities predominantly caused by Polio. The eradication of Polio has seen a shift in its use to the correction of other complex hind foot deformities. The technique has relevance in modern Orthopaedics for other neurological and degenerate conditions. There have been few published series of this technique since 1927.

We describe a series of 14 complex corrective triple arthrodeses to illustrate the power of Lambrinudi's concepts. We believe Lambrinudi's original description has relevance in terms of modern day complex hindfoot deformity correction.

PURPOSE

To report the experience and evolution of treatment of Congenital Pseudarthrosis of the Tibia in a single surgeon, consecutive series of 19 patients.

To investigate the relationship between age and the Constant score: A formula to correct for age.

Method and results Healthy volunteers from the King’s College Hospital population with no previous shoulder disease were assessed using the constant score.270 healthy shoulders were tested. The subjects’ ages ranged from 16 to 83 with a mean age of 44.3. The scores ranged from 60 to 100 with a mean score of 82.3. Pearson correlation analysis gave us a trend or slope of −0.1.

Corrected score= actual score −[(age-44)( −0.1)].

Conclusion We concluded that the constant score decreases with age at a rate of one point per decade and that in order to compare subjects’ scores in a standardised way this correction should be applied.