Neuromuscular Issues in Cavovarus Foot

Krause, Fabian; Wing, Kevin; Younger, Alastair

doi:10.1016/j.fcl.2008.02.003

Cited by 35 publications

(18 citation statements)

References 22 publications

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“…The Coleman block test is commonly used in cavovarus feet to determine whether the contracture involves the forefoot, hindfoot, or both. 54–56 The patient stands on a wood block 2.5 to 4 cm thick with the heel and lateral border of foot on the block with the first three metatarsals hanging freely over the block. This negates the effect the forefoot may have on the hindfoot stance.…”

Section: Management Of Contracturesmentioning

confidence: 99%

“…57 Rarely is TAL needed to correct a cavovarus foot because the calcaneus is already in calcaneus or dorsiflexion (Figure 2). 54–56 TAL may worsen the cavus deformity by tilting the hindfoot into more calcaneus and the forefoot into more equinus to maintain ground contact. A dorsal closing wedge osteotomy of the midfoot at the apex of the cavus foot deformity is often performed in CMT (Figure 3).…”

Section: Management Of Contracturesmentioning

confidence: 99%

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Prevention and Management of Limb Contractures in Neuromuscular Diseases

Skalsky

McDonald

2012

Physical Medicine and Rehabilitation Clinics of North America

126

101

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Synopsis Limb contractures are a common impairment in neuromuscular diseases (NMD). They contribute to increased disability due to decreased motor performance, mobility limitations, reduced functional range of motion, loss of function for activities of daily living (ADL), and increased pain. The pathogenesis of contractures is multifactorial. Myopathic conditions are associated with more severe limb contractures in comparison to neuropathic disorders. Although the evidence supporting the efficacy of multiple interventions to improve ROM in NMD in a sustained manner is lacking, there are generally accepted principles with regard to splinting, bracing, stretching, and surgery that help minimize the impact or disability from the contractures.

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Section: Management Of Contracturesmentioning

confidence: 99%

Section: Management Of Contracturesmentioning

confidence: 99%

Prevention and Management of Limb Contractures in Neuromuscular Diseases

Skalsky

McDonald

2012

Physical Medicine and Rehabilitation Clinics of North America

126

101

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“…Upper and lower motor neuron diseases such as cerebral palsy, spina bifida, arthrogryposis, and residual poliomyelitis often cause severe and rigid deformities in the foot and ankle [16,17,19]. Treatment of a rigid neurologic foot deformity is rather difficult and relapse of the deformity is a common problem [5].…”

Section: Introductionmentioning

confidence: 99%

Application of the Ilizarov Technique to the Correction of Neurologic Equinocavovarus Foot Deformity

Lee

Choi

Yoo

et al. 2011

Clinical Orthopaedics &Amp; Related Research

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Background The treatment of rigid equinocavovarus foot deformities caused by neurologic disorders is often difficult and relapse is common. Questions/purposes We asked whether the Ilizarov technique could be used for correction of neurologic equinocavovarus foot deformities resulting in improved foot and ankle function and patient satisfaction. Patients and Methods The neurologic equinocavovarus foot deformities of 26 patients (mean age, 18.7 years; 29 feet) were treated using the Ilizarov technique. Nine feet were treated by distraction histiogenesis only with limited soft tissue release, whereas 20 feet needed additional osteotomy and/or tendon transfer/lengthening. Minimum followup was 12 months (mean, 72.9 months; range, 12-155 months). Results The mean time required for deformity correction was 27.1 days (range, 14-47 days) and the mean time for stabilization in the apparatus was 23.2 days (range, 7-53 days). A painless, stable, and plantigrade result was obtained by 22 patients (24 feet). Mild residual foot deformity was observed in the remaining five feet of four

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“…Os calçados devem ser comuns, mas confortáveis e de caixa alta, para acomodar o pé e a palmilha. Órteses semirrígidas para alinhamento do retropé, inclusive com barras estabilizadoras laterais, podem ser prescritas nos casos mais graves e com instabilidade lateral no tornozelo (47) , mas são de pouca aceitação pelo desconforto e comprometimento estético que apresentam.…”

Section: Tratamento Conservadorunclassified

“…Esse procedimento, herança das técnicas usadas nas sequelas de poliomielite, tem a vantagem de restabelecer um pé plantígrado, mantendo o equino do retropé, ou seja, sem enfraquecer mais o tríceps sural. Além disso, o equino que surge na extensão do joelho e desaparece com a sua flexão pode ser adequadamente tratado com o alongamento seletivo do gastrocnêmio (31,47) . Já o alongamento do tendão de Aquiles no pé calcaneocavo constitui iatrogenia, pois piora a marcha em calcâneo (33) .…”

Section: Tratamento Cirúrgicounclassified

Pé cavo adquirido na doença de Charcot-Marie-Tooth

Maranho

Volpon

2009

Rev. bras. ortop.

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rESUMOAs neuropatias sensitivomotoras hereditárias, principalmente a doença de Charcot-Marie-Tooth, manifestam-se frequentemente com o aparecimento de pé cavovaro, deformidade caracterizada pela acentuação fixa do arco plantar e inversão do retropé. O diagnóstico da doença de base e a cuidadosa avaliação do paciente fornecem os elementos-chave para decisão do tratamento. O cavo pode situar-se no antepé, retropé ou ser o resultado da associação das duas localizações. Deformidades combinadas, principalmente varismo e garras dos artelhos, devem ser bem avaliadas; as características clínicas como grau das alterações, acometimento da força muscular, flexibilidade e idade são fatores importantes para a decisão da conduta. O tratamento conservador do pé cavovaro por meio de fisioterapia, palmilhas e adaptação nos calçados é reservado ao paciente mais jovem ou casos levemente acometidos. Entretanto, há tendência de agravamento das deformidades devido à característica progressiva da doença neurológica de base. Assim, o tratamento cirúrgico pelas técnicas clássicas é indicado precocemente, sendo importante identificar as alterações primárias, diferenciá-las das secundárias e corrigi-las, se possível. As transferências musculares são usadas no sentido de minimizar o desequilíbrio, estruturas retraídas são seccionadas ou alongadas e osteotomias localizadas devem ser preferíveis às artrodeses, que são reservadas para pés rígidos e muito deformados de pacientes adultos.

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Neuromuscular Issues in Cavovarus Foot

Cited by 35 publications

References 22 publications

Prevention and Management of Limb Contractures in Neuromuscular Diseases

Prevention and Management of Limb Contractures in Neuromuscular Diseases

Application of the Ilizarov Technique to the Correction of Neurologic Equinocavovarus Foot Deformity

Pé cavo adquirido na doença de Charcot-Marie-Tooth

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