Long-term outcome of extraarticular subtalar arthrodesis in children with cerebral palsy using modified Grice technique


subtalar arthrodesis; cerebral palsy; foot deformities; pes equinus

Published online: Aug 23 2022


Jiri Jochymek, Tereza Peterkova

From the Department of Paediatric Surgery, Orthopaedics and Traumatology (DPSOT) of the Children´s Medical Centre (CMC), Faculty Hospital in Brno, and Medical Faculty of the Masaryk University in Brno, Czech Republic


The purpose of the study is to describe and analyse long-term results of the modified Grice procedure with specially prepared pre-shaped autograft from iliac crest. 54 patients (101 feet) who underwent modified Grice procedure, were retrospectively analysed. Before and after the surgery, talocalcaneal (TC) angle and calcaneal inclination (CI) angle were measured and compared with post-operative values. Furthermore, AOFAS score was assess pre-and postoperatively as well as the subjective evaluation of the patients or their parents. Detailed analysis was performed separately for patients with different forms of CP. Postoperatively, TC angle and subjective assessment decreased, and CI angle and AOFAS score increased significantly compared to pre-operative values. The significant difference was observed among different CP groups in all observed parameters. Severe complications were not observed. The modified Grice procedure with specially prepared pre-shaped autograft showed promising long-term results.