Clinical correlates of charcot–marie–tooth disease in patients with pes cavus deformities

Karakis, Ioannis; Gregas, Matt; Darras, Basil T.; Kang, Peter B.; Jones, H. Royden

doi:10.1002/mus.23622

Cited by 24 publications

(23 citation statements)

References 35 publications

(76 reference statements)

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“…Interestingly, 63% of patients with pes cavus had a diagnosis of CMT1A genetically confirmed, whereas pes cavus was less frequently observed in other subtypes of inherited neuropathy. These data confirm previous studies in which the presence of pes cavus ranged between 40% and 77% in CMT1A patients, [9][10][11][12] suggesting the role of muscular imbalance between anterolateral and posteromedial compartments in the pathogenesis of pes cavus. 12 The relatively rarer presence of foot deformities in other subtypes of CMT, such as in HMN, could be explained by the differing muscular involvement with both anterior and posterior compartment muscles affected.…”

Section: Discussionsupporting

confidence: 91%

Prevalence and orthopedic management of foot and ankle deformities in Charcot–Marie–Tooth disease

et al. 2017

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Introduction: Foot deformities are frequent complications in Charcot–Marie–Tooth disease (CMT) patients, often requiring orthopedic surgery. However, there are no prospective, randomized studies on surgical management, and there is variation in the approaches among centers both within and between countries. Methods: In this study we assessed the frequency of foot deformities and surgery among patients recruited into the Inherited Neuropathies Consortium (INC). We also designed a survey addressed to orthopedic surgeons at INC centers to determine whether surgical approaches to orthopedic complications in CMT are variable. Results: Foot deformities were reported in 71% of CMT patients; 30% of the patients had surgery. Survey questions were answered by 16 surgeons working in different specialized centers. Most of the respondents were foot and ankle surgeons. There was marked variation in surgical management. Discussion: Our findings confirm that the approaches to orthopedic management of CMT are varied. We identify areas that require further research. Muscle Nerve 57: 255–259, 2018

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Section: Discussionsupporting

confidence: 91%

Prevalence and orthopedic management of foot and ankle deformities in Charcot–Marie–Tooth disease

et al. 2017

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“…Its clinical manifestations include steppage gait, midfoot pain, pain and ulceration in the head of metatarsal, joint stiffness, instability of the lateral ankle, and other symptoms [12-14]. The surgical correction of pes cavus is intended to eliminate pain, restore plantigrade foot confirmation and recover the balance of bone alignment, muscle forces and joint mobility [2,15,16].…”

Section: Discussionmentioning

confidence: 99%

A prospective study of midfoot osteotomy combined with adjacent joint sparing internal fixation in treatment of rigid pes cavus deformity

Zhou

Liu

et al. 2014

J Orthop Surg Res

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BackgroundMidfoot osteotomy has been previously confirmed to be a good method to correct pes cavus. How to fix the osteotomy and which point to choose for the procedure has been a focus for most surgeons. The aim of this study was to analyse the outcomes of a series of patients who had been treated for pes cavus deformity using midfoot osteotomy combined with adjacent joint sparing internal fixation.Materials and methodsBetween 2008 and 2012, 17 patients with a mean age of 16.8 years (12–36 years) were tracked after treatment by midfoot osteotomy combined with adjacent joint sparing internal fixation with three cannulated screws between the Lisfranc line and Cyma line. Clinical outcomes were assessed by measuring improvements of appearance and function, American Orthopedic Foot and Ankle Society (AOFAS) scores, and radiographic changes.ResultsThe mean follow-up time was 25.3 months (range, 10–50). The mean healing time from the osteotomy was 7.8 weeks (range, 6–12). The appearance and weight-bearing function were significantly improved in all patients. At a final follow-up, the mean AOFAS score was 75.8/100 points (range, 63–90). The mean Meary's angle, calcaneal pitch angle, tibiotalar angle, and Hibb's angle values improved from 26.3 to 5.5, 44.5 to 28.3, 133.1 to 100.8 and 66.9 to 41.1, respectively. Adjacent joints presented no obviously arthritic degeneration at the follow-up. Subjectively, 94.1% of patients were very satisfied or satisfied with minor reservations. Objective outcomes were excellent or good in 88.2% of feet.ConclusionFor the treatment of rigid pes cavus deformity, extra-articular midfoot osteotomy combined with adjacent joint sparing internal fixation is effective and safe. This surgical technique is especially effective with low rates of arthritic degeneration and joint stiffness in the adjacent joints and little reduction of ankle and foot flexibility.

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“…Between 50% and 80% of such foot problems, particularly if bilateral, are eventually proved to be caused by CMT. 51 Although some asymmetry in foot alignment exists in some children, it is not a typical finding 52,53 ; therefore it is important to consider diagnoses other than CMT in asymmetric cases (eg, spinal cord disease and mononeuropathies). Significant discrepancy between the degree of symptoms and weakness or sensory deficit can often be seen on physical examination.…”

Section: Clinical Featuresmentioning

confidence: 99%

Pediatric Charcot-Marie-Tooth Disease

Jani‐Acsadi

Õunpuu

Pierz

et al. 2015

Pediatric Clinics of North America

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Clinical correlates of charcot–marie–tooth disease in patients with pes cavus deformities

Abstract: In children with pes cavus, certain clinical features can predict CMT and assist in selection of patients for further, potentially uncomfortable (EMG) and expensive (genetic) confirmatory investigations.

Cited by 24 publications

References 35 publications

Prevalence and orthopedic management of foot and ankle deformities in Charcot–Marie–Tooth disease

Prevalence and orthopedic management of foot and ankle deformities in Charcot–Marie–Tooth disease

A prospective study of midfoot osteotomy combined with adjacent joint sparing internal fixation in treatment of rigid pes cavus deformity

Pediatric Charcot-Marie-Tooth Disease

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