tailieunhanh - Báo cáo y học: "Split tendon transfers for the correction of spastic varus foot deformity: a case series study"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Split tendon transfers for the correction of spastic varus foot deformity: a case series study. | Vlachou and Dimitriadis Journal of Foot and Ankle Research 2010 3 28 http content 3 1 28 JOURNAL OF FOOT AND ANKLE RESEARCH RESEARCH Open Access Split tendon transfers for the correction of spastic varus foot deformity a case series study Maria Vlachou1 Dimitris Dimitriadis1 2 Abstract Background Overactivity of anterior and or posterior tibial tendon may be a causative factor of spastic varus foot deformity. The prevalence of their dysfunction has been reported with not well defined results. Although gait analysis and dynamic electromyography provide useful information for the assessment of the patients they are not available in every hospital. The purpose of the current study is to identify the causative muscle producing the deformity and apply the most suitable technique for its correction. Methods We retrospectively evaluated 48 consecutive ambulant patients 52 feet with spastic paralysis due to cerebral palsy. The average age at the time of the operation was 12 4 yrs 9-18 and the mean follow-up 7 8 yrs 4-14 . Eigtheen feet presented equinus hind foot deformity due to gastrocnemius and soleus shortening. According to the deformity the feet were divided in two groups Group I with forefoot and midfoot inversion and Group II with hindfoot varus . The deformities were flexible in all cases in both groups. Split anterior tibial tendon transfer SPLATT was performed in Group I 11 feet while split posterior tibial tendon transfer SPOTT was performed in Group II 38 feet . In 3 feet both procedures were performed. Achilles tendon sliding lengthening Hoke procedure was done in 18 feet either preoperatively or concomitantly with the index procedure. Results The results in Group I were rated according to Hoffer s clinical criteria as excellent in 8 feet and satisfactory in 3 while in Group II according to Kling s clinical criteria were rated as excellent in 20 feet good in 14 and poor in 4. The feet with poor results presented residual varus deformity