Results of Triple Arthrodesis in Uganda.

Background: In Uganda, foot deformities of various kinds and complexities are common. The aim of this study was to evaluate and determine whether triple arthrodesis is an effective and reasonable operation in the African perspective.
Method: The study population consisted of 36 patients who had triple athrodesis between 1996 and 2000. A questionnaire was designed on which information obtained from hospital and outpatient notes were recorded. The data obtained was analysed.
Results: The patients'ages ranged between 6 and 20 years with an average of 12.75 years. The deformities were due to post-polio paralysis and congenital clubfoot in 44% and 33% respectively. A total of 94% of the patients were satisfied with the operation. Using the Mackenzie grading system as adapted for Hallglimson (1943) that emphasizes function, the results were obtained good in 28 feet (67%), fair in 12 (25%) were a failure in 2(8%). There was no gender difference in outcome. The responses in the age groups 10 years and below and above 10 years were not statistically different (P = 0.14). Mild residual deformity, not hindering daily activity, was noted in 26 of the 42 feet. Pseudoarthrosis was found in 14 feet in which 12 involved the talonaricular joint.
Conclusion: In the developing world triple arthrodesis still has a role to play in treatment of feet deformities. The results obtained in this study were worse than those obtained in the developed countries due to the fact that our patients presented late but even those that presented early received inadequate treatment.