One-Stage Pantalar Arthrodesis for Ankle-Foot Deformity in Post-Poliomyelitis Patients

Post-poliomyelitis foot deformity remains a challenging problem to orthopedic surgeons, though its incidence has decreased greatly. The purpose of this retrospective study was to evaluate the surgical outcome in patients with paralytic foot deformity associated with poliomyelitis. Between 1998 and 2002, seven patients with a history of prolonged, severe, and rigid equinocavovarus deformity secondary to poliomyelitis underwent one-stage deformity correction and pantalar arthrodesis. Their average age at the time of surgery was 54 years and the average follow-up was 22 months. Fixation with multiple cannulated screws, bone staples, or K-wires was used in all patients. After surgery, no vascular insufficiency or skin sloughing developed. At the latest follow-up, solid arthrodesis was achieved in all patients and none of the deformities recurred. Painless plantigrade feet were achieved in all patients but one. Leg length discrepancy averaged 2.7 cm (range, 2-4.5 cm), which was managed with shoe lifts. In conclusion, with stringent preoperative evaluation, meticulous surgical technique, and highly compliant postoperative cast protection, one-stage deformity correction and pantalar arthrodesis can be successfully accomplished in patients with severe, rigid equinocavovarus deformity secondary to poliomyelitis.