Long-term Outcome of Planovalgus Foot Surgical Correction in Children with Cerebral Palsy

Double Column Foot Osteotomy to Correct Flexible Valgus Foot Deformity in Children with Spastic Cerebral Palsy

“…These changes include external rotation of the calcaneus, and internal rotation and inferior subluxation of the talus. Additional structural alterations develop because of the abnormal forces applied through the mid-and forefoot and loss of stability, which result in midfoot break [13]. Foot pain accompanies the foot deformity and results from midfoot break with prominant talar head in the weightbearing part of the foot [11,13].…”

“…Additional structural alterations develop because of the abnormal forces applied through the mid-and forefoot and loss of stability, which result in midfoot break [13]. Foot pain accompanies the foot deformity and results from midfoot break with prominant talar head in the weightbearing part of the foot [11,13]. Radiographically, there is increase in the anterior talocalcaneal Kite's angle, talonavicular angle, talonavicular coverage angle, anterior talo-first metatarsal angle, lateral talocalcaneal angle and lateral talo-first metatarsal Meary's angle [14][15][16][17][18].…”

Pes planovalgus deformity in children with cerebral palsy

“…The benefits of mobilizing the forefoot and midfoot segments through the osteotomy site are tightening of the plantar fascia and reduction in the position of the talus over the calcaneus without damaging the joint motion. Calcaneal lengthening has been commonly used for CP children with planovalgus foot deformity with good results [10][11][12][13][14][15][16].…”

“…Intra-articular subtalar fusion has been also utilized in CP children for correction of planovalgus deformity [15,16,26]. The utilization of two screws to reduce the subtalar joint was previously described by Judet as Cavalier's Procedure, where no decortication of the articular surfaces was performed [27].…”

“…The debate on whether severe planovalgus feet can be corrected with calcaneal lengthening in children with CP [10,11] or whether this technique is applicable only for flexible and less severe planovalgus feet in good ambulators [12][13][14][15][16]34] persists; however, the exact indications are not very widely established.…”