eISSN: 2077-9135 / ISSN: 1681-5491
Register
Login
Medical Channel Journal
2011, Volume 17, Issue 3 : 21-24
Research Article
Surgical treatment of equinovarus deformity of foot in children with cerebral palsy
 ,
 ,
1
Department of Orthopaedics and Traumatology, Liaquat University of Medical and Health Sciences, Jamshoro, Hyderabad Sindh, Pakistan
2
Department of Plastic, Reconstructive and Burns Surgery, Pakistan
3
Department of Neurosurgery, Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan
Abstract

Introduction:Foot deformities e.g., ankle equinus, equinovarus and equinovalgus, are common in patients with CP. Varus deformity which is usually accompanied by equinus, is commonly caused by an abnormal posterior tibial muscle,anterior tibial muscle or both. If left untreated, may cause severe fixed foot deformity.Various methods of treatment have been reported. Material and Method: Twenty patients (25 feet) were included in this study.The patients were assessed clinically and patients with forefoot varus and aquinus were treated by split transfer of tibialis anterior to the cuboid and patients with hind foot varus and equinus were treated by split transfer of tibialis posterior tendon through interosseous membrane, to the lateral cuniform. Percutaneus lengthening of tendocalcaneus was performed in all patients. The outcome was analyzed. Results:The age range at the start of study was between six to ten years (mean 8years.), and at the last follow up was eight to fourteen years (mean 11.5 years). Mean follow-up was 3.5 years.The range of varus deformity was 15 0to 20 0 and range of equinus was between 16 0 to 25 0. Split transfer of tibialis anterior tendon was performed in seven patients (8feet) presenting with fore foot varus and equinus. Split transfer of tibialis posterior tendon was performed in thirteen patients (17 feet) presenting with hind foot varus and equinus. Percutaneustendocalcaneuas lengthening was done in all cases. Open release of planter fascia was performed in fourteen feet as there was mild cavus deformity. The results were graded according to Kling's clinical criteria. The results were excellent in fourteen feet, good in 7 feet, and poor in four feet. Poor results were seen in four of our patients with marked tendocalcaneus shortening, as the deforming force was not successfully determined clinically in these cases. Most of our patients had excellent results. Conclusion: split tibialis anterior tendon transfer to cuboid in patients with forefoot varus and split tibialis posterior tendon transfer through interosseous membrane to lateral cuniform in patients with hind foot varus, are good and rewarding procedures. However accurate diagnosis of deforming muscle i.e, tibialis anterior or tibialis posterior is essential to produce good results.

Keywords
License
Copyright (c) Medical Channel Journal
Creative Commons Attribution License Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.
All papers should be submitted electronically. All submitted manuscripts must be original work that is not under submission at another journal or under consideration for publication in another form, such as a monograph or chapter of a book. Authors of submitted papers are obligated not to submit their paper for publication elsewhere until an editorial decision is rendered on their submission. Further, authors of accepted papers are prohibited from publishing the results in other publications that appear before the paper is published in the Journal unless they receive approval for doing so from the Editor-In-Chief.
Med. Channel J. open access articles are licensed under a Creative Commons Attribution-ShareAlike 4.0 International License. This license lets the audience to give appropriate credit, provide a link to the license, and indicate if changes were made and if they remix, transform, or build upon the material, they must distribute contributions under the same license as the original.
Recommended Articles
Knowledge and practices of barbers about hepatitis "B" transmission in district swat of Khyber pakhtoonkuah province of Pakistan
13-17
Frequency of mitral valve stenosis among adult patients of rheumatic heart disease admitted in lumhs and mmc
39-42
Induction of labor by oral and vaginal misoprostol in slum area of karachi
58-60
Protective role of vitamin c on proximal convoluted tubules of albino rats in streptozotocin induced diabetes
28-32
Medical Channel Journal
support@medicalchanneljournal.pk
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives (CC BY-NC-ND) license. Open Access Publication.
Copyright © ©Medical Channel Journal. All rights reserved.