Is Further Corrective Surgery After a Grice-Green Procedure Ill-Advised?

Question: I had a Grice-Green procedure in 1955 to correct toe drop and weak foot muscles in my right foot secondary to polio. I have had outstanding results since then. Though I have a gait specific to my disability, I am a hiker and can walk with good hiking boots for as far as eight miles. This is becoming more difficult as my ankle is becoming more pronated. The original surgery fused the right subtalar joint on the right foot and the tendon transfer was attached on the right so that the foot toes out to the right and the ankle collapses more. I am having more difficulty walking for any distance with just sneakers and an orthotic for foot support. Is further corrective surgery ill advised?

Answer: After 55 years of use, what is likely wearing out is your tendon transfer. This can result in more foot pronation and troubles. Your two options are an AFO designed to support your ankle/foot or to consider some type of surgery, likely a fusion. The latter is rarely done in older people because of circulatory concerns and slow bony fusion, with new pain problems common. The other limitation is expert surgeons who use effective procedures — I know of only very few and the best ones are very selective in who they will do a procedure on.

If you are committed to pursuing a surgical opinion, let us (PHI) know where you live so we can attempt to find some recommended names or institutions in your part of the country for you. I can’t guarantee or endorse them, but we are willing to use our networking resources to find some surgeons for you to consult and get opinions if you desire.

Post-Polio Health (Vol. 29, No. 2, Spring 2013)