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Hey, I have a 50 yr old patient with spina bifida resulting in L/ anterior pes cavus. She actually does very well and doesn't have a lot of problems at this point but way interested in surgical options in the long run. At this point she can get to 90 at the ankle with an additional 5-6 degrees. Muscle power is actually not bad but poor endurance. She does get footdrop but only when fatigued. I've read about triple arthrodesis being helpful. What is the success rate? At what point does surgery become the best option? Orthopedic surgeons handle this up here but I'm curious to know other people's experience with treating this. Conservatively we discussed stretching, strengthening, orthotics and appropriate footwear.

Thanks!!