Calcaneal Lengthening for Planovalgus Deformity in Children with Cerebral Palsy

2009 ◽  
Vol 30 (5) ◽  
pp. 398-404 ◽  
Author(s):  
Volker Ettl ◽  
Nicole Wollmerstedt ◽  
Stephan Kirschner ◽  
Robert Morrison ◽  
Eva Pasold ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Relapse Rate ◽  
Clinical Result ◽  
Foot Deformities ◽  
Radiological Outcome ◽  
Foot Deformity ◽  
High Relapse Rate ◽  
Children With Cerebral Palsy ◽  
Clinical And Radiological Outcome ◽  
Calcaneal Lengthening

Background: In children with cerebral palsy, planovalgus deformity of the foot is common. The aim of this study was to evaluate the outcome of calcaneal lengthening for the treatment of planovalgus foot deformity in children with cerebral palsy. Materials and Methods: We reviewed 19 children (28 feet) treated between 1996 and 2004 in our institution. There were 14 ambulating (19 feet) and 5 nonambulating children (9 feet). The average age of the children at time of surgery was 8.6 years. Followup averaged 4.3 years. Results: We found satisfactory results in 75% of the feet clinically and in 79% radiologically according to Mosca's criteria. We saw no overcorrection but a relapse of the deformity in seven cases. There were six unsatisfactory radiological results, two (out of 19) in the ambulating and four (out of nine) in the nonambulating group. Ambulating children had a significantly better clinical and radiological outcome than nonambulating children ( p = 0.042). A significant correlation was found between Ankle-hindfoot Score and clinical result according to Mosca's criteria ( p = 0.001). Conclusion: In ambulatory children with cerebral palsy calcaneal lengthening is an effective procedure for the correction of mild to moderate planovalgus foot deformities. In nonambulatory children with severe plano-valgus deformities of the foot, calcaneal lengthening cannot be recommended because of the high relapse rate in these patients.

scholarly journals Calcaneal lengthening for the pes planovalgus foot deformity in children with cerebral palsy

2020 ◽  
Vol 11 (2) ◽  
pp. 245-250 ◽  
Author(s):  
Aly Mohamed Aboelenein ◽  
Mohamed Lotfy Fahmy ◽  
Hassan Magdy Elbarbary ◽  
Abobakr Zein Mohamed ◽  
Sherif Galal
Keyword(s):  
Cerebral Palsy ◽  
Pes Planovalgus ◽  
Foot Deformity ◽  
Children With Cerebral Palsy ◽  
Calcaneal Lengthening

scholarly journals TARSAL COALITIONS IN CHILDREN WITH CEREBRAL PALSY: CLINICAL OBSERVATION AND TREATMENT STRATEGY

2014 ◽  
Vol 2 (1) ◽  
pp. 13-17
Author(s):  
Vladimir Markovich Kenis ◽  
Andrei Viktorovich Sapogovsky ◽  
Ruslan Khalilovich Husainov
Keyword(s):  
Computed Tomography ◽  
Cerebral Palsy ◽  
Surgical Treatment ◽  
Surgical Management ◽  
Clinical Observation ◽  
Foot Deformities ◽  
Foot Deformity ◽  
Tarsal Coalition ◽  
Children With Cerebral Palsy ◽  
Diagnostic Confusion

Tarsal coalition is a congenital anomaly of the foot, characterized by later appearance of the clinical and radiological signs, which become obvious in adolescents. Tarsal coalitions in children with cerebral palsy can lead to diagnostic confusion, as well as to complicate natural course of foot deformity and surgical treatment. The paper presents first experience with the systematized data for tarsal coalitions in children with cerebral palsy. Among 157 children operated for foot deformities this anomaly was identified in 4 patients (incidence - 2,5 % in our series). Clinical and radiological descriptions, surgical management, including complications, are presented for these cases, which demonstrate significance of tarsal coalitions for diagnostics, surgical management and prognosis. Information and caution, regarding tarsal coalitions in children with cerebral palsy, who undergo surgical treatment for foot deformities, as well as advanced methods of diagnostics (magnetic resonance and computed tomography), are required in order to avoid preventable complications.

scholarly journals Radiographic Analysis of Surgically Treated Flatfoot Deformity in Children with Cerebral Palsy

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0028
Author(s):  
Alicia Kerrigan ◽  
Waleed Kishta
Keyword(s):  
Cerebral Palsy ◽  
Surgical Intervention ◽  
Pes Planovalgus ◽  
Foot Deformity ◽  
Radiographic Parameters ◽  
Radiographic Measurements ◽  
Children With Cerebral Palsy ◽  
Before And After ◽  
Lengthening Osteotomy ◽  
Calcaneal Lengthening

Category: Midfoot/Forefoot Introduction/Purpose: Pes planovalgus is the most common foot deformity in children with cerebral palsy (CP). Many of these patients become functionally limited and require surgical intervention. The objectives of this study are to apply previously validated radiographic parameters to radiographs of children with CP who have undergone surgical intervention for pes planovalgus deformity and to assess if these radiographic parameters show improvements post-operatively. Furthermore, this study aims to determine which of these parameters can most accurately be used to quantify correction post-surgery. Methods: A retrospective review was performed to identify patients aged five to 17 with a diagnosis of CP who underwent lateral calcaneal lengthening osteotomy for pes planovalgus between 2006 and 2015 at London Health Sciences Center. The previously validated radiographic measurements were applied to pre-operative and post-operative radiographs. A normality test was performed to observe whether participants were normally distributed with regard to the severity of their deformity. Paired T-test and Wilcoxon signed-rank test were used to compare changes in radiographic measurements from before and after surgery. Results: Seventeen patients met the inclusion criteria. The average age of selected patients was 13.06 years (range 9.42-16.75 years). This included 11 males and six females, all with spastic CP (12 diplegic, five hemiplegic). Of these patients, 11 underwent bilateral surgery and six underwent unilateral surgery (28 feet). These patients were followed post-operatively for a mean of 7.97 months (range 1.5-20 months). In comparing the radiographs from before and after surgery, statistically significant changes were seen in five out of the seven measurements. Talonavicular coverage angle was found to have the most significant change post-correction. Conclusion: The previously validated radiographic parameters used to assess foot and ankle deformity can be applied to the surgically treated pes planovalgus foot in patients with CP. It was found that five out of the seven measurements used to assess foot deformity changed significantly with surgical intervention. Talonavicular coverage angle was found to be the most accurate measure for post-surgical correction. This is the first study to apply these parameters to CP patients with surgically treated flatfoot deformity. Lateral calcaneal lengthening osteotomy significantly improves these radiographic measures.

Limits of Calcaneal Lengthening for Treating Planovalgus Foot Deformity in Children With Cerebral Palsy

2017 ◽  
Vol 38 (8) ◽  
pp. 863-869 ◽  
Author(s):  
Chi-An Luo ◽  
Hsuan-Kai Kao ◽  
Wei-Chun Lee ◽  
Wen-E Yang ◽  
Chia-Hsieh Chang
Keyword(s):  
Cerebral Palsy ◽  
Foot Deformity ◽  
Children With Cerebral Palsy ◽  
Calcaneal Lengthening

scholarly journals Selective dorsal rhizotomy opportunities with foot deformitiesin children with cerebral palsy

2015 ◽  
Vol 3 (1) ◽  
pp. 22-26
Author(s):  
Vladimir Markovich Kenis ◽  
Stanislav Vyacheslavovich Ivanov ◽  
Tatiana Ilinichna Kiseleva
Keyword(s):  
Cerebral Palsy ◽  
Foot Deformities ◽  
Total Thickness ◽  
Foot Deformity ◽  
Selective Dorsal Rhizotomy ◽  
Dorsal Rhizotomy ◽  
Management Protocol ◽  
Children With Cerebral Palsy ◽  
Foot Posture ◽  
Calf Muscles

Foot deformities are the most common orthopedic condition in children with cerebral palsy. The aim of the study was to evaluate the influence of selective dorsal rhizotomy (SDR) on foot deformities in children with cerebral palsy. The results were assessed clinically by measurement of changes in muscle spaticity and foot posture. Percentage of resection of dorsal rootlets was from 40 to 90 % of total thickness. The degree of tone reduction had a tendency to be more pronounced in the more proximal muscles and was minimal in calf muscles. Nevertheless, foot posture improved more significantly. That can be explained by generalimprovement of pathological posture at the level of more proximal joints. Thus, SDR has insignificant direct effect on spastic foot deformity and can not be recommended as a basic method of treatment even in pure spasticity. However, SDR should be considered as a part of multidisciplinary management protocol if foot deformity reflects more complex postural disturbance due to generalized spasticity.

Calcaneal Lengthening for the Planovalgus Foot Deformity in Children With Cerebral Palsy

2005 ◽  
Vol 25 (6) ◽  
pp. 781-785 ◽  
Author(s):  
Won Joon Yoo ◽  
Chin Youb Chung ◽  
In Ho Choi ◽  
Tae-Joon Cho ◽  
Dong Han Kim
Keyword(s):  
Cerebral Palsy ◽  
Foot Deformity ◽  
Children With Cerebral Palsy ◽  
Calcaneal Lengthening
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