Patient-Reported Pain and Function Outcomes in Children With Congenital Vertical Talus Treated With the Minimally Invasive Method

Background: In 2006, a new minimally invasive method was introduced for the definitive correction of congenital vertical talus (CVT) deformity. There are no studies to date that have utilized the Patient-Reported Outcome Measurement Information System (PROMIS) to evaluate long-term quality of life outcomes in these patients. Methods: We identified all children with CVT who underwent treatment with the minimally invasive method and were seen at our institution after 2015. A retrospective chart review was then performed on these patients, and PROMIS scores were recorded for the following domains: Pain Interference, Mobility, and Peer Relations. Subgroup analysis was performed on patients who experienced recurrence and those who required a second corrective surgery. An alpha level of 0.05 was used for all analyses. Results: There were 24 children who were treated for CVT at our institution after 2015 and had completed PROMIS surveys. Seven (29.2%) of these patients developed recurrence during the follow-up period. Among the entire cohort, the mean PROMIS pain interference score was 48±9, the mean PROMIS mobility score was 42±13, and the mean PROMIS peer relations score was 54±9. There were no statistically significant differences in the PROMIS scores between the entire cohort and those who experienced radiographic recurrence in any of the 3 domains (P>0.05). Children who initiated treatment after the age of 12 months had lower PROMIS mobility scores than those who initiated treatment before 12 months of age (32.48 vs. 47.31, P=0.02). Conclusion: On average, children who undergo treatment with this technique end up within 1 SD of the reference population in all 3 domains that were measured (pain interference, mobility, and peer relations) regardless of sex, age, and status of recurrence. However, there was a trend towards lower mobility scores in this population compared with the reference population (42±13 vs. 50±10). Treatment should be initiated at less than 12 months of age whenever possible to maximize patient-reported outcomes. Level of Evidence: Level III.