Tarsal fusion for pes equinovarus deformity improves gait capacity in chronic stroke patients.

The study included only 10 patients and had no control group, so improvement after surgery cannot be separated from time, training, or other changes. The surgery was not one single intervention; many patients also had Achilles tendon lengthening, gastrocnemius slide, toe flexor tenotomy, toe arthrodesis, extensor hallux longus lengthening, or first metatarsal osteotomy, so the effect of tarsal fusion alone cannot be known. The sample was small and one patient had missing nonparetic kinematic data. Outcomes were measured in a laboratory at one time point, not in daily life, and postoperative assessment occurred between 2 and 11 months after surgery. Patient reported satisfaction and barefoot capacity were subjective, and the study did not compare surgical correction with non surgical management. All patients were selected for gait problems related to pes equinovarus and had no previous ankle or foot orthopedic surgery, so results may not apply to all stroke patients.

Do not conclude that tarsal fusion alone caused the better walking. The patients had several foot procedures at once, including tendon, toe, and foot bone procedures, and the study had no control group.