Rigid foot and ankle deformities can be caused by flat feet, trauma, high arched feet, and many other factors. This case is an example from Dr. Barnett of a club foot from child birth that needed surgery once bracing was no longer effective. Children and flexible problems can often be fixed with tendon transfers and soft tissue release. This case needed fusion to recorrect deformity.
CT scan showing the TN joint (Talus and Navicular) nearly dislocated and arthritic. Xrays showed the severe ankle varus position but CT showed the image in 3D and was good for surgery planning in which a surgery called a pantalar fusion was needed. That involves fusing the TN joint, Ankle joint, subtalar joint, and often CC joint. It makes hindfoot rigid but corrects position and reduces pain and is often the only surgery someone will ever need for the deformity.
Intraop picture per Dr. Barnett. Front xray of ankle with a nail and screws realigning the ankle and foot. The fibula was cut down and used for bone graft.
The foot xrays showed excellent alignment. Pt will be walking in 8-12 weeks in a protected boot and free from bracing in 3-4 months