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The Journal of Bone and Joint Surgery, Vol 71, Issue 3 417-422, Copyright © 1989 by Journal of Bone and Joint Surgery, Inc
Long-term results of triple arthrodesis in Charcot-Marie-Tooth disease
RS Wetmore and JC Drennan
Department of Orthopaedic Surgery, Newington Children's Hospital.
We evaluated sixteen patients who had Charcot-Marie-Tooth disease and had
had a total of thirty triple arthrodeses. The average age at the time of
operation was fifteen years, and the average length of follow-up was
twenty-one years. Of the thirty feet, the result in two (7 per cent) was
rated excellent; in five (17 per cent), good; in nine (30 per cent), fair;
and in fourteen (47 per cent), poor. Each of the fourteen feet that had a
poor result had severe impairment of function and needed an orthosis. Six
limbs had an arthrodesis of the ankle for degenerative joint disease.
Progressive muscle imbalance resulted in recurrent cavovarus deformity in
seven feet that initially had had satisfactory alignment. Degenerative
changes of the ankle and joints of the mid-part of the foot were noted
radiographically in twenty-three feet. The large number of unsatisfactory
long-term results in these patients who had had a triple arthrodesis for
deformity of the foot secondary to progressive peripheral neuropathy
differs from those in earlier reports on patients who had poliomyelitis,
who retained normal sensation and had a permanent, stable muscle imbalance.
We believe that triple arthrodesis should be considered only as a salvage
procedure in patients who have progressive peripheral neuropathy and should
be limited to those who have severe, rigid deformity.
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