Subtalar Extra-articular Arthrodesis for Correction of Paralytic Valgus Deformity of the Foot: Evaluation Of Forty-four Procedures With Particular Reference To Associated Tendon Transference

1. The subtalar extra-articular arthrodesis is a well devised, mechanically sound, and reasonably simple procedure, affording good results in the operative management of paralytic valgus deformities in feet of young children. 2. When equinus deformity is present in addition to valgus deformity, lengthening of the Achilles tendon is recommended to allow the foot to assume the plantigrade position and possibly to avert recurrent valgus deformity. 3. When active peroneal muscles are contributing to the deformity it is not necessary to remove them in order to achieve good results after the Grice procedure. 4. When there is an associated weakness in plantar flexion or in dorsiflexion, transference of one of the peroneal tendons to the mid-line may provide added strength in anterior-posterior ankle motion. 5. If a peroneal tendon is transferred, we recommend that it not be inserted past the mid-line, as it may contribute to eventual overcorrection and varus deformity. If both peroneal tendons are transferred, we recommend sectioning of the posterior tibial tendon regardless of its clinical strength.