足と足首の臨床研究

抽象的な

Double Column Foot Osteotomy to Correct Flexible Valgus Foot Deformity in Children with Spastic Cerebral Palsy

Sherif Bishay, George Magdy Morshed, Yehia Tarraf, Naguib Pasha

Backgound: Mobile (flexible or correctable) hindfoot valgus deformity is common in children with spastic cerebral palsy (CP). It is accompanied by short lateral and long medial foot column.
Patients and Methods: Eleven ambulatory children (20 feet) suffering spastic cerebral palsy (CP), two hemiplegic and nine diplegic, presenting with mobile (flexible) hindfoot valgus deformity, were evaluated neurologically, orthopaedically, and radiographically, and operated upon in the National Institute of Neuromotor System between September 2012 and September 2013. Double column foot osteotomy with medial cuneiform closing-wedge and cuboid opening-wedge without attacking the calcaneus was performed in all of them.
Results: The results were followed-up clinically and radiographically over a period ranging from a year and half (18 months) to two years (24 months) with an average of a year and 9 months (21 months), and were graded into four categories as excellent, good, fair, and poor according to the total calculated score. According to the suggested grading system, there were 8 excellent results, 8 good results, 4 fair results, and no poor results.
Conclusion: Double column foot osteotomy shortening the medial foot column and lengthening the lateral foot column to correct moderate to severe hindfoot valgus in ambulatory children with spastic cerebral palsy (CP), compared favourably with similar series, and offered option for achieving foot alignment, improving pain and skin problems and avoiding the problems associated with arthrodesis. Level of Evidence: The study is type IV therapeutic level of evidence.