Talectomy and tibio-calcaneal fusion using Wright Ortholoc posterior TTC fusion plate
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Pes planus is the deformity of the foot characterised by loss of the medial longitudinal arch with the foot under loading. More often than not, the hindfoot also lies in valgus deriving the term pes planovalgus. Secondary features of this deformity are that there may be a compensatory supination deformity of the midfoot and the Achilles tendon tightens and effectively becomes shorter in length.
There are multiple causes of pes planovalgus that can broadly be separated into congenital (eg tarsal coalition, hypermobility syndromes) and acquired groups. In adults, acquired pes planovalgus is most often seen with posterior tibial tendon dysfunction or with inflammatory arthopathies. Careful assessment of the patient’s symptoms and signs is necessary to guide the treatment options available for each individual patient.
Talectomy and tibiocalcaneal fusion is not a common procedure for pes planovalgus. Historically, it is more often associated with the management of fixed equinovarus deformities in childhood (eg arthrogryposis, post CTEV), Charcot arthropathy or post-traumatic deformity (invariably secondary to the loss of the talus). In this particular case, a 65 year old lady with rheumatoid arthritis presented with a stiff, painful flat foot. All footwear modifications had failed to relieve her symptoms.
Author:Mr Mark Davies FRCS(Tr & Orth)
Institution: The Northern general hospital, Sheffield, UK.
- Each operation and the questions associated become a named course in the CPD section
- The operative technique itself is read as a lesson as is any company implant information if this is being assessed.
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- There are additional quiz modules on the surgical steps, the implants and problem cases being added continually
- The course is completed once all the lessons are read and quizzes submitted and passed.
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The pass mark is 75%.
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- Operation Quiz – 1 CPD point
- Surgical steps Quiz – 1/4 CPD point
- Implants Quiz – 1/4 CPD point
- Problem case Quiz – 1/2 CPD point
One CPD point equates to one hour of academic activity
Welcome to the Professional Development question section. The objective of taking these tests is to demonstrate that you have understood all aspects of the assessment and management of patients requiring surgical intevention. On successful completion you will receive a certificate accredited by both the Royal College of Surgeons of both England and Edinburgh as well as the British Orthopaedic Association.
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