PMC6588141_01
Pre-operative clinical picture showing gross deformity of the left foot.
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F1
She presented with pain and callosities on the lateral border of the feet and was unable to fit the left foot into regular shoes (Fig. 1).
Pre-operative standing anteroposterior X-rays.
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F2
The rigid equinocavovarus deformity on the left was visibly worse with forefoot adduction and pronation (Fig. 2), resulting in weight bearing only on the dorsolateral surface of the foot.
Pre-operative left ankle lateral X-ray showing flattop talus.
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F3
Of note was the presence of a flat-top talus on the left foot (Fig. 3), indicative of abnormal growth of the talus.
Radiograph showing the right foot after hexapod frame application using a TrueLok-Hex Frame  (a) and a photo image of the left foot during fixation treatment using a TaylorSpatial Frame  (b).
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F4
Taylor Spatial Frame (Fig. 4). The right foot was treated in a similar fashion using a TrueLok-Hex Frame (Orthofix Verona, Italy) (Fig. 4). The procedures were combined with triple arthrodesis, and reduction and union were achieved using distraction osteogenesis.
Lateral X-ray of the left (a) and right (b) foot 12 months after removal of external fixator showing union of the triple arthrodesis.
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F5
On the right, a residual equinus deformity of 20  remained (Fig. 5)shows a united triple arthrodesis on the left and right.
Side view of both feet showing clinically plantigrade feet post-correction.
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F6
Fig. 6 and 7show the correction achieved clinically.
Front view of both feet showing clinically plantigrade feet post-correction.
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F7
Fig. 6 and 7show the correction achieved clinically.