Incidence and Predictors of Flat-Top Talus in Ponseti-Treated Clubfeet

Description

In this presentation, Maryse Bouchard, a pediatric orthopedic surgeon at the Hospital for Sick Children, discusses her research on the incidence and predictors of flat-top talus in children treated for clubfoot using the Ponseti method. She begins by thanking her co-authors and noting that none of the authors have any relevant disclosures. Bouchard explains that flat-top talus is a deformity associated with surgically treated clubfeet, which can lead to complications such as ankle impingement and arthritis, although its incidence has decreased with the use of the Ponseti method.



The study aims to determine the occurrence of flat-top talus in treated patients and identify risk factors. It was a retrospective cohort study involving children enrolled in a clubfoot research registry, including patients seen between 2005 and 2018. Following a detailed analysis, the study found only a small subset of patients met the inclusion criteria. Key findings indicate that the group with flat-top talus experienced higher rates of relapse, more casting series, and greater total casting since birth, suggesting a link between these factors and the development of the flat-top deformity.



Bouchard also highlights additional surgical interventions, noting that patients in the flat-top group had more instances of repeat casting and surgeries compared to the round talus group, although these differences did not reach statistical significance. She concludes by emphasizing the importance of monitoring flat-top talus in children with clubfoot relapse, advocating for timely surgical intervention over prolonged casting to mitigate the risk of iatrogenic complications. The presentation wraps up with thanks to the audience for their attention.

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