Mohd Luqman Bin Haji ANUAR, Norazian Binti KAMISAN, Imma Isniza Binti ISMAIL
Medical Science and Discovery - 2026;13(9):325-332
Objective: Arthrogrypotic equinocavovarus is a rigid, multiplanar deformity that frequently recurs after casting and soft-tissue surgery. Talectomy removes the talus as a mechanical block and permits realignment of a severely constrained hindfoot. This series describes its use in two children of different ages and mobility levels. Case report : A 12-year-old independently ambulant girl presented with painful recurrent bilateral equinocavovarus after infant casting and soft-tissue releases. Bilateral talectomy and calcaneocuboid releases were performed during multilevel lower-limb reconstruction. A 5-year-old supported walker with arthrogryposis, bilateral developmental dysplasia of the hip and recurrent rigid right equinocavovarus underwent right talectomy concurrently with hip reconstruction. In all three feet, talar excision created space for the calcaneus to be repositioned beneath the distal tibia. Temporary transcalcaneal Kirschner wires and casts maintained the corrected relationship. All reported outcomes were limited to the index admission: the feet were plantigrade and well perfused, with no immediate neurovascular compromise. Neither child had assessment after K-wire or cast removal; therefore, post-immobilisation follow-up was 0 months for both cases. Discussion: Talectomy can provide direct hindfoot correction when recurrence is global and rigid and useful ankle movement is already markedly restricted. Selection should be guided by deformity rigidity, previous treatment, pressure-related skin changes, residual movement and ambulatory potential rather than age alone. Complete excision, accurate calcaneal positioning and correction of residual equinus, midfoot or toe deformity remain important technical considerations. Validated deformity scores, goniometric range-of-motion measurements and reproducible pre- and postoperative radiographic angles were not available. The absence of post-immobilisation follow-up prevents assessment of maintained correction, ambulation, orthotic or footwear tolerance, recurrence and later skin complications. Conclusion: Talectomy permitted immediate plantigrade realignment in a supported walker and an independent ambulator. Without post-immobilisation follow-up or standardised functional and radiographic assessment, maintenance of correction, ambulation and recurrence cannot be determined.
