Talectomíaa propósito de un caso

  1. Eduardo Simón Pérez 1
  2. Joaquín Páez Moguer 2
  3. Rafael González Úbeda 3
  4. Alfonso Martínez Nova 4
  5. Luke D. Cicchinelli
  6. José I. Rodríguez Mateos 5
  7. Clarisa Simón Pérez 6
  8. Susana Zurro González 7
  1. 1 Centro Médico Recoletas Angustias. Valladolid
  2. 2 Universidad de Málaga.
  3. 3 Universidad Católica San Antonio
    info

    Universidad Católica San Antonio

    Murcia, España

    ROR https://ror.org/05b1rsv17

  4. 4 Universidad de Extremadura
    info

    Universidad de Extremadura

    Badajoz, España

    ROR https://ror.org/0174shg90

  5. 5 Hospital Universitario Río Hortega. Valladolid
  6. 6 Hospital Clínico Universitario. Valladolid
  7. 7 Centro de Salud La Puebla, Palencia
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Revista:
Revista española de podología

ISSN: 0210-1238

Ano de publicación: 2021

Volume: 32

Número: 2

Páxinas: 140-145

Tipo: Artigo

DOI: 10.20986/REVESPPOD.2021.1616/2021 DIALNET GOOGLE SCHOLAR lock_openAcceso aberto editor

Outras publicacións en: Revista española de podología

Resumo

Talectomy is a rescue technique for certain severe deformities, such as equinus varus foot. This procedure can be performed when other less aggressive treatments cannot correct the deformity. We present a case of a 70-year-old patient with a chronic ulcer at the level of the fourth and fifth metatarsophalangeal joints that communicates, through fistulous pathway, the sole of the foot with the dorsum. This ulceration is due to a large deformity in rigid varus equine (secondary to poliomyelitis) that prevents it from walking normally. The patient had rejected a below-knee amputation approach and was offered the option of a talectomy, as an option for reconstructive surgery. The surgical treatment consisted in the removal of the talus along with reduction of the deformity with 2 temporary Steinmann pin, z-plasty of the Achilles tendon, resection of the first metatarsal head by dorsal incision and temporary fixation with Steinmann pins, complete removal of the fifth ray and removal of the second, third and fourth metatarsal heads. Immediate postoperative visits and 3-month and 1-year reviews were performed. One year after the procedure, the patient presented a nonpainful plantigrade gait, showing great improvement without recurrence of plantar ulcers. We found that talectomy could be a viable treatment as part of reconstructive surgery for severe foot and ankle pathology in patients with severe neuropathy and that it could be a viable option before considering a major amputation.

Referencias bibliográficas

  • Seletti M, D´Elia M, Radkievich R, Sancevich J, Calvi J, Slullitel G.Astragalectomy: functional and radiological evaluation. Tobillo Pie. 2016;8(1):79-85.
  • Ferrández Portal L. Cirugía tumoral. Pautas generales de tratamiento. En: Núñez-Samper Pizarroso M, Llanos Alcázar LF, Viladot Pellicer R, editores. Técnicas quirúrgicas en cirugía del pie. Barcelona: Masson; 2003. p. 261-7.
  • Atef A, El-Rosasy M, El Tantawy A. Talectomy for the management of resistant talipes equinovarus deformity; does adding ilizarov external fixator provide extra advantages? J Foot Ankle Surg. 2021;60(2):307-11. DOI: 10.1053/j.jfas.2020.08.033.
  • Menelaus MB. Talectomy for equinovarus deformity in arthrogryposis and spina bifida. J Bone Joint Surg Br. 1971;53(3):468-73. DOI: 10.1302/0301-620X.53B3.468.
  • Langan T, Lalli TAJ, Smith CN, Wukich DK. Talectomy as part of chronic foot and ankle deformity correction procedure: a retrospective study. J Foot Ankle Surg. 2020;59(1):16-20. DOI: 10.1053/j.jfas.2019.05.002.
  • Pons Cabrafiga M. Cirugía de las infecciones óseas. En: Núñez-Samper Pizarroso M, Llanos Alcázar LF, Viladot Pellicer R, editored. Técnicas quirúrgicas en cirugía del pie. Barcelona: Masson; 2003. p. 307-12.
  • El-Sherbini MH, Omran AA. Midterm follow-up of talectomy for severe rigid equinovarus feet. J Foot Ankle Surg. 2015;54(6):1093-8. DOI: 10.1053/j.jfas.2015.07.004.
  • Riley D, Barber M, Kienle G, Aronson J, von Schoen-Angerer T, Tugwell P, et al. CARE guidelines for case reports: explanation and elaboration document. J Clin Epidemiol. 2017;89:218-35. DOI: 10.1016/j.jclinepi.2017.04.026.
  • Nozaki S, Watanabe K, Kamiya T, Katayose M, Ogihara N. Morphological variations of the human talus investigated using three-dimensional geometric morphometrics. Clin Anat. 2021;34(4):536-43. DOI: 10.1002/ca.23588.
  • Georgiev H, Georgiev G. Talectomy for equinovarus deformity in family members with hereditary motor and sensory neuropathy type I. Case Rep Orthop. 2014;643480. DOI: 10.1155/2014/643480.
  • Lewis GS, Kirby KA, Piazza SJ. Determination of subtalar joint axis location by restriction of talocrural joint motion. Gait Posture. 2007;25(1):63-9. DOI: 10.1016/j.gaitpost.2006.01.001.
  • Mahato NK, Narayana Murthy S. Articular and angular dimensions of the talus: Inter-relationship and biomechanical significance. Foot. 2012;22:85-9. DOI: 10.1016/j.foot.2011.12.003.
  • Siegler S, Toy J, Seale D. New observations on the morphology of the talar dome and its relationship to ankle kinematics. Clin Biomech. 2014;29(1):1-6. DOI: 10.1016/j.clinbiomech.2013.10.009.
  • Joseph T, Myerson M. Use of talectomy in modern foot and ankle surgery. Foot Ankle Clin. 2004;9(4):775-85. DOI: 10.1016/j.fcl.2004.06.007.
Fonte de datos: Dialnet