Talonavicular Arthrodesis for the Treatment of Neurological Flat Foot Deformity in Pediatric Patients

Coulon, Geraldo De; Turcot, Katia; Canavese, Federico; Dayer, Romain; Kaelin, André; Ceroni, Dimitri

doi:10.1097/bpo.0b013e31821fffa0

Cited by 23 publications

(26 citation statements)

References 20 publications

(36 reference statements)

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“…Этот факт свидетельствует о щадящем характере оперативного воздействия и наличии условий для более ранней, чем у других исследователей нагрузки на конечность (через 2 нед. после операции с дополнительными средствами опоры) [2,9,15] .…”

Section: Discussionunclassified

“…В сравнении с работами наших коллег, которые исключают нагрузку на оперированную стопу при трехсуставном артродезе в течение 1,5-2 мес. [2,9,15], что доставляет ряд неудобств и ограничений, в том числе психологических, мы рекомендуем вертикализацию с постепенно возрастающей нагрузкой на оперированный сегмент через 2 нед. после операции с дополнительными средствами опоры.…”

Section: Discussionunclassified

“…У детей дошкольного возраста, больных церебральным параличом (ЦП) преобладает эквинусный компонент деформации [1]. Однако у детей старшего возраста, подростков и взрослых с этим заболеванием чаще встречается плосковальгусная деформация стоп, которая является одной из главных причин неустойчивости при вертикализации [2][3][4][5][6][7].…”

Section: Introductionunclassified

“…Детям старшего возраста и взрослым с деформациями стоп рекомендуют выполнять корригирующие остеотомии костей стопы, артроэрез, стабилизирующие операции [2][3][4][9][10][11][12][13]. Однако реконструктивное вмешательство на стопе за счет остеотомии при ригидных выраженных деформациях костей и изменениях суставного хряща (остеоартроз 2-3 ст.)…”

Section: Introductionunclassified

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Correction of Foot Deformities using Triple Arthrodesis and Its Effect on Soft Tissue Blood Supply at Surgical Site in Patients with Cerebral Palsy

Leonchuk

Щурова

Popkov

et al. 2018

Traumatology and Orthopedics of Russia

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The aim of the studyis to evaluate the efficiency of triple arthrodesis of foot and its effect on soft tissues blood supply at the surgical site during simultaneous correction of segment deformity in patients with cerebral palsy.Material and Methods. The present study reflects the authors’ experience of triple arthrodesis for correction and stabilization of foot multicomponent deformities of varying severity in 75 patients (136 feet) with cerebral palsy (IIIV level by Gross Motor Function Classification System (GMFCS)) treated in the Ilizarov center in the period from April 2012 to December 2016. The average age of the patients was 16.4±4.3 years (from 11 years 8 months to 43 years 3 months). All patients included into the study had severe arthrosis of hind and midfoot. The main option of foot fixation in this group of patients was internal fixation (elastic threaded wires, compression screws) together with plaster cast immobilization for 6–8 weeks. All patients underwent average of 4.59 surgical elements during a procedure as part of simultaneous multilevel interventions. The blood supply at the surgical site was evaluated by laser and high-frequency Doppler flowmetry before and after all stages of the surgery.Results.Long-term outcomes were evaluated at the average of 19 months after the surgery in 56 (74.7%) patients. 37 patients (66.1%) demonstrated good treatment outcomes and 19 patients (33.9%) — satisfactory outcomes. No unsatisfactory outcomes were observed. The clinical outcome of foot surgery was evaluated using the Angus-Cowell criteria. The obtained significant x-ray enhancement was maintained at the control stages of the follow up. Despite large simultaneous correction of foot deformity, there was no decrease in the parameters of microcirculatory blood supply of the skin, muscles and subcutaneous fat of the foot. The authors observed a stabilized or an increased perfusion of soft tissues.Conclusion.Triple arthrodesis for correction of foot deformities in patients with cerebral palsy and severe arthrosis in hind and midfoot is an efficient method which allows to correct and stabilize gained position of segments. The data of physiological research testify the sparing approach of such procedure and a possibility of an earlier weight-bearing on operated limb.

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Section: Discussionunclassified

Section: Introductionunclassified

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Correction of Foot Deformities using Triple Arthrodesis and Its Effect on Soft Tissue Blood Supply at Surgical Site in Patients with Cerebral Palsy

Leonchuk

Щурова

Popkov

et al. 2018

Traumatology and Orthopedics of Russia

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“…Lateral column lengthening has been advocated [33], but some authors report an unacceptable recurrence rate in children with a neurologic cause [34]. de Coulon et al [36] report satisfactory clinical and radiographic results using this technique. Talonavicular fusion has recently been presented as an option for this population.…”

Section: Rigid Neurologic Flatfootmentioning

confidence: 99%

Pediatric flatfoot

Dare

Dodwell

2014

Current Opinion in Pediatrics

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Pediatric flatfeet range from the painless flexible normal variant of growth, to stiff or painful manifestations of tarsal coalition, collagen abnormalities, neurologic disease, or other underlying condition. Most children with flexible flatfeet do not have symptoms and do not require treatment. In symptomatic children, orthotics, osteotomies, or fusions may be considered. Arthroereisis has gained popularity in Europe, but has not been widely adopted in North America. Children with asymptomatic rigid flatfeet may not require treatment, whereas those with pain or functional deficits may benefit from orthotics, osteotomies, or fusions. A careful history, clinical exam, and selective diagnostic testing can be used to determine the appropriate treatment option for each child.

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