Errors and complications in surgical treatment of non-stable equino-plano-valgus foot deformity in patients with cerebral palsy, with use of the calcaneus correcting osteotomy technique

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Aims. To examine the results of treatment for patients with a non-stable form of equino-plano-valgus foot deformity in cerebral palsy with the use of corrective osteotomy of the calcaneus. To further analyze the errors and complications that occurred in patients treated with this technique.

Materials and methods. From 2006 to 2014, 64 patients (103 feet) aged 3 to 17 years were operated using the described method of calcaneus correcting osteotomy. The equinus contracture was eliminated by transection of the gastrocnemius muscle tendon and extending achilloplastic surgery. The abnormal muscle tone was reduced either by administering the drug Dysport into the gastrocnemius muscle or by selective neurotomy of the tibial nerve.

Results. The analysis revealed that there were good results for 75%, satisfactory results for 18%, and unacceptable results for 7% of patients. The unacceptable results of treatment were due to several technical and tactical errors, which were grouped and analyzed.

Conclusion. The analysis of errors and complications of calcaneus corrective osteotomy for patients with cerebral palsy with a mobile form of talipes equinoplanovalgus will enable their future avoidance and improvement of the treatment quality.

作者简介

Valery Umnov

The Turner Scientific and Research Institute for Children’s Orthopedics

编辑信件的主要联系方式.
Email: umnovvv@gmail.com

MD, PhD, professor, head of the department of infantile cerebral palsy

俄罗斯联邦

Dmitry Umnov

The Turner Scientific and Research Institute for Children’s Orthopedics

Email: dmitry.umnov@gmail.com

MD, PhD, research associate of the department of infantile cerebral palsy

俄罗斯联邦

参考

  1. Yoon HK, Park KB, Roh JY, et al. Extraarticular subtalar arthrodesis for pes planovalgus: an interim result of 50 feet in patient with spastic diplegia. Clin Orthop Surg. 2010;2(1):13-21. doi: 10.4055/cios.2010.2.1.13.
  2. Kim JR, Shin SJ, Wang SI, Kang SM. Comparison of lateral opening wedge calcaneal osteotomy and medial calcaneal sliding-opening wedge cuboid-closing wedge cuneiform osteotomy for correction of planovalgus foot defomity in children. J Foot Ancle Surg. 2013;52(2):162-166. doi: 10.1053/j.jfas.2012.12.007.
  3. Rhodes J, Mansour A, Frickman A, et al. Comparison of allograft and bovine xenograft in calcaneal lengthening osteotomy for flatfoot in cerebral palsy. J Pediatr Orthop. 2016:1. doi: 10.1097/bpo.0000000000000822.
  4. Waizy H, Plaass C, Brandt M, et al. Extra-articular arthrodesis according to Grice/Green versus calcaneal lengthening according to Evans: retrospective compatision for therapy of neurogenic pes planjvalgus. Der Orthopade. 2013;42(6):409-417. doi: 10.1007/s00132-013-2090-4.
  5. Патент РФ на изобретение № 2311145/27.11.07. Бюл. № 33. Умнов В.В., Долженко Н.В., Умнов Д.В. Способ лечения плоско-вальгусной деформации стопы у детей. [Patent RUS 2311145/ 27.11.07. Byul. No 33, Umnov VV, Doljenko NV, Umnov DV. Sposob lecheniy plosco-valgusnoy deformatsii stopi u detei. (In Russ.)]
  6. Ragab AA, Steward SL, Cooperman DR. Implications of subtalar joint anatonic variation in calcaneal lenthening osteotomy. J Pediatr Orthop. 2003;23(1):79-83. doi: 10.1097/01241398-200301000-00016.

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