Modified Grice–Green subtalar arthrodesis performed using a partial fibular graft yields satisfactory results in patients with cerebral palsy

Güven, Melih; Tokyay, Abbas; Akman, Budak; Encan, Mehmet E; Altıntaş, Faik

doi:10.1097/bpb.0000000000000264

Cited by 9 publications

(5 citation statements)

References 26 publications

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“…The Grice-Green procedure has been frequently used, with different modifications, but mainly in young patients affected by neurological foot deformities and without subtalar arthritis. 3,14,20,22,25 This procedure presents the benefits, not to be underestimated, of correcting hindfoot malalignment by restoring the correct relationship of the talus with the calcaneus and navicular, without the need for internal screw fixation.…”

Section: Discussionmentioning

confidence: 99%

Outcome After Modified Grice-Green Procedure (SAMBB) for Arthritic Acquired Adult Flatfoot

et al. 2020

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Background: Adult acquired flatfoot deformity is a well-known and recognized cause of pain and disability. The purpose of this retrospective study was to describe radiographic and clinical outcomes of the modified mini bone block distraction subtalar arthrodesis (SAMBB) in adult patients affected by adult flatfoot with subtalar joint osteoarthritis at a midterm mean follow-up. Methods: A retrospective review of our database identified patients. Radiological imaging was used to evaluate angular corrections (Meary’s angle [MA], talar coverage angle [TC], and calcaneal pitch angle [CP]) to assess the rate of union and highlight the possible progression of arthritis in nearby joints. Clinical evaluation was performed at the time of surgery and at the final follow-up using the American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot score. Sixty-two feet were evaluated at a mean follow-up of 6.2 ± 4.2 years. Results: The AOFAS score improved from a mean value of 48.1 ± 6.1 to a postoperative average score of 87.7 ± 5. CP, TC, and MA showed a postoperative improvement to 17.7 ± 2.1, 2.9 ± 0.7, and 0.6 ± 0.6 degrees, respectively, at the final follow-up, and all deformities were corrected. Five complications (8%) were reported: 1 major and 4 minor. No graft reabsorption, sural nerve neuralgia, or donor site morbidity was recorded. Conclusions: To our knowledge, this study is the first report of a modified Grice-Green technique (SAMBB) that is a safe and effective treatment of flatfoot in the adult with subtalar arthritis. Level of evidence: Level IV, retrospective case series.

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Section: Discussionmentioning

confidence: 99%

Outcome After Modified Grice-Green Procedure (SAMBB) for Arthritic Acquired Adult Flatfoot

et al. 2020

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“…Подальше вивчення результатів застосування цього методу показало наявність можливих ускладнень у вигляді резорбції трансплантата, його переломів, втрати досягнутої корекції [4,13]. Для усунення ускладнень запропоновано заповнення sinus tarsi фрагментом крила клубової кістки або малогомілкової кістки [12]. Недоліками методів є додаткова операційна травма та наявність косметичних дефектів.…”

Section: результати дослідження та їх обговоренняunclassified

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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“…Consequently, it is more suitable for nonambulatory patients [163][164][165][166]. The Grice extra-articular subtalar arthrodesis can effectively correct valgus without affecting the normal growth of tarsal bone [167,168]. However, there are risks of postoperative complications, including graft delayed healing, dissolution, dislocation, and fracture of the surgical site in this type of surgery.…”

Section: Ankle Surgerymentioning

confidence: 99%

Orthopedic treatment of the lower limbs in spastic paralysis

Deng

Zeng

et al. 2020

Brain Science Advances

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Spastic paralysis of the limb mainly results from the central lesion, in which spastic cerebral palsy is the common cause. Due to durative muscle spasm in spastic cerebral palsy, it is often accompanied by the formation of secondary musculoskeletal deformities, resulting in limb motor disability. Based on its pathogenesis, surgical treatment is currently applied: selective posterior rhizotomy (SPR) or orthopedic surgery. The primary purpose of early orthopedic surgery was simply to correct limb deformities, which usually led to the recurrence of deformity as a result of the presence of spasticity. With the application of SPR, high muscle tone was successfully relieved, but limb deformity was still present postoperatively. Therefore, this study aimed to elaborate on the management of orthopedic surgery, common deformities of the lower limb, and orthopedic operative methods; discuss the relationship between SPR and orthopedic procedure for limb deformity; and focus on the indications, timing of intervention, and postoperative outcome of different surgical methods.

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Modified Grice–Green subtalar arthrodesis performed using a partial fibular graft yields satisfactory results in patients with cerebral palsy

Cited by 9 publications

References 26 publications

Outcome After Modified Grice-Green Procedure (SAMBB) for Arthritic Acquired Adult Flatfoot

Outcome After Modified Grice-Green Procedure (SAMBB) for Arthritic Acquired Adult Flatfoot

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

Orthopedic treatment of the lower limbs in spastic paralysis

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