Valgus tilting of the ankle joint after subtalar (hindfoot) fusion: complication or natural progression of valgus hindfoot deformity?

Six patients treated over a 2-year period were noted to have valgus tilting of the talus at the ankle joint on standing anteroposterior ankle films taken after subtalar (hindfoot) fusions. All patients had significant preoperative hindfoot valgus, but no changes on ankle films. All patients underwent "moldable insitu fusions." Severity and duration of preoperative deformity, as well as obesity, appear to be predisposing factors. Most patients were satisfied with their pain relief despite their persistent valgus deformity. Treatment alternatives may include medial displacement calcaneal osteotomy, lateral column lengthening, combination bone and soft tissue procedures, or even tibial talar calcaneal fusion.