Management of Severe Equinovalgus in Patients With Cerebral Palsy by Naviculectomy in Combination With Midfoot Arthrodesis

Dussa, Chakravarthy U.; Döderlein, Leonhard; Forst, Raimund; Böhm, Harald; Fujak, Albert

doi:10.1177/1071100717709577

Cited by 8 publications

(4 citation statements)

References 56 publications

(63 reference statements)

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“…Chakravarty Dussa та співавт. рекомендують видалення човноподібної кістки та артродез суглобів середнього відділу стопи для відновлення склепіння [10].…”

Section: оригінальні дослідження ортопедіяunclassified

Analysis of the effectiveness of methods of correction of pronation deformities of the feet in children with cerebral palsy

Danilov,

Gorelik,

Shulga

2023

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Pronation deformities of the feet are one of the most common childhood deformities requiring surgical treatment. For correction subtalar arthroereisis and subtalar arthrodesis according to Grice are used. The use of these methods in combination with the transposition of the gastrocnemius muscle is promising. Purpose - тo study the effectiveness of subtalar arthroereisis and subtalar arthrodesis according to Grice in combination with transposition of the gastrocnemius muscle in the correction of pronation deformity of the feet in children with cerebral palsy. Materials and methods. The results of treatment of 40 patients aged 7 to 16 years with pronation deformity of the feet were analyzed. Patients were divided into 2 groups. The main group (25 patients) was divided into 2 subgroups depending on the method of surgical treatment: the subgroup A - 10 patients who underwent subtalar arthroereisis with transposition of the tendon of the short peroneal muscle; the subgroup B - 15 patients who underwent subtalar arthrodesis according to Grice with transposition of the tendon of the short peroneal muscle. The control group included 15 patients who underwent subtalar arthrodesis according to Grice. Clinical and radiological methods were used to examine patients. Numerical data were compared between groups and processed statistically with the determination of M±m and the coefficient of reliability by Student’s t-test. The level of probability was set at p<0.05. Results. The advantage of subtalar arthroereisis and subtalar arthrodesis according to Grice in combination with transposition of the gastrocnemius muscle is the elimination of its pronation pathological effect on the foot, increased supination effect of the posterior tibialis muscle, as well as reduced compression on the autoimplant when performing subtalar arthrodesis according to Grice. Conclusions. The effectiveness of peroneal tendon transposition in combination with subtalar arthroereisis or arthrodesis in the correction of pronation deformity of the feet in children with cerebral palsy has been proven, which allows improving clinical and radiological parameters after treatment. The study was conducted in accordance with the principles of the Declaration of Helsinki. The study protocol was approved by the local ethics committees of all institutions participating in the study. Informed consent was obtained from the patients. No conflict of interests was declared by the authors.

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Section: оригінальні дослідження ортопедіяunclassified

Analysis of the effectiveness of methods of correction of pronation deformities of the feet in children with cerebral palsy

Danilov,

Gorelik,

Shulga

2023

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“…The results of salvage strategies, such as triple arthrodesis, can often be problematic, with poor long-term outcomes including pain, arthritis, and poor foot function. 1,7,17 Historically, combined medial and lateral column procedures were often employed to correct resistant foot deformities secondary to TEV or congenital vertical talus. 7,9 Naviculectomy was originally described as a salvage procedure primarily for cases of resistant congenital vertical talus deformity.…”

Section: Introductionmentioning

confidence: 99%

“…The results of salvage strategies, such as triple arthrodesis, can often be problematic, with poor long-term outcomes including pain, arthritis, and poor foot function. 1,7,17…”

Section: Introductionmentioning

confidence: 99%

“…1,7,17 Historically, combined medial and lateral column procedures were often employed to correct resistant foot deformities secondary to TEV or congenital vertical talus. 7,9 Naviculectomy was originally described as a salvage procedure primarily for cases of resistant congenital vertical talus deformity. 2,3 Mubarak and Dimeglio expanded the use of this procedure in children with rigid cavus deformity.…”

Section: Introductionmentioning

confidence: 99%

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Outcomes of Naviculectomy for Severe Recurrent Clubfoot Deformity

Westberry

Carpenter

Brown

et al. 2021

Foot & Ankle Orthopaedics

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Background: Naviculectomy was originally described for resistant congenital vertical talus deformity but was later expanded to use in rigid cavus deformity. This study reviews the operative outcomes of complete excision of the navicular for recurrent deformity in the talipes equinovarus (TEV) population. Methods: After institutional review board approval, all patients undergoing naviculectomy at a single institution were identified. Clinical, radiographic, and pedobarographic data (minimum 2 years’ follow-up) were reviewed. Results: Twelve patients (14 feet) with TEV from 1984 to 2019 were included. All feet had minimum 1 prior operative intervention on the affected foot (mean age = 4.0 years, range 0.2-14.5), with 8/14 having at least 3 prior operative procedures. Complete navicular excision with concomitant procedures was performed in all patients (mean age = 11.7 years, range 5.5-16.1). Mean clinical follow-up from naviculectomy was 5.1 years (range, 2.2-11.2). During follow-up, 6 patients required subsequent surgery, most often secondary to pain and progressive deformity. One patient underwent elective below-knee amputation of the affected extremity. Of the remaining 11 patients, 7 of 11 reported continued pain and 8 of 11 maintained adequate range of motion at the ankle at the most recent follow-up. Conclusion: Clinical follow-up demonstrated deteriorating results in a large percentage of patients. The high rate of additional procedures and continued pain in the current series suggests that even as a salvage procedure, naviculectomy may not provide adequate results for patients. Level of Evidence: Level IV, case series.

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Neurogenic Deformities (Except Cavovarus Deformity)

Hämel

2021

Foot and Ankle Surgery in Children and Adolescents

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Management of Severe Equinovalgus in Patients With Cerebral Palsy by Naviculectomy in Combination With Midfoot Arthrodesis

Abstract: Level IV, retrospective case series.

Cited by 8 publications

References 56 publications

Analysis of the effectiveness of methods of correction of pronation deformities of the feet in children with cerebral palsy

Analysis of the effectiveness of methods of correction of pronation deformities of the feet in children with cerebral palsy

Outcomes of Naviculectomy for Severe Recurrent Clubfoot Deformity

Neurogenic Deformities (Except Cavovarus Deformity)

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