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125648

CORRECTION OF PES PLANOVALGUS IN CEREBRAL PALSY: A SHORT TERM OUTCOME OF EXTRA-ARTICULAR SUBTALAR ARTHRODESIS

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Last updated: 26 Dec 2024

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Abstract

Background: Pes planovalgus is the most common foot deformity observed in cerebral palsy (CP) patients causing pain, gait abnormality, instability and in severe deformity. It can lead to brace intolerance. The treatment of this deformity should be directed to correct the foot malalignment, secure the stability of the foot during stance and correct the abnormal gait. After failure of conservative treatment, surgical treatment is the option. It varies from simple soft tissue procedures to tarsal osteotomies, subtalar extra-articular arthrodesis, intra-articular arthrodesis and triple arthrodesis. When these are compared, all techniques have advantages and disadvantages. Aim of the Work: This prospective clinical study is conducted to evaluate the short term outcome of the extra-articular subtalar arthrodesis using fibular graft that harvested from the junction between the proximal 1/3 and the distal 2/3 of the fibula in correction of flexible pes planovalgus in children with cerebral palsy. Patients and methods: We conducted a prospective study involving 13 patients (22 feet) with cerebral palsy who failed conservative treatment for more than 6 months. Postoperative complications were recorded. Assessment of the patients clinically and radiologically was done and compared to that of the preoperative data. Results: Clinical results were satisfactory in 21 feet and unsatisfactory in 1 foot according to kim et al scoring system. Radiologically; the anteroposterior talocalcaneal angle decreased from the median of 2°6 (range 1°1 – 5°6 ) preoperative to 9°.5 (range °1 – 3°5 ) post operative. The lateral talocalcaneal angle deceased from the mean of 42.0°5 ± 7.3°5 preoperative to 28.7°3 ± 8.5°1 postoperative. The anteroposterior talus-first metatarsal angle decrease from the median of 2°4 (range° 3 – 5°5 ) preoperative to° 8 (range° 1 – 3°9 ) postoperative. The lateraltalus-first metatarsal angle
decreased from the median of 2°0 (range °3 – 4°7 ) preoperative to 8°.5 (range °0 – 1°8 ) postoperative and the calcaneal pitch angle increased from the median of °5 (range -1°9 – 2°2 ) preoperative to 1°0 (range °2 – 1°7 ) postoperative. The postoperative changes were statistically highly significant. Conclusion: The extra-articular subtalar arthrodesis in our study as in others had been proved to be effective, safe, simple and non expensive procedure for correction of flexible pes planovalgus feet in children with cerebral palsy.

DOI

10.21608/asmj.2020.125648

Keywords

Extra-articular subtalar arthrodesis, Grice Green procedure, valgus feet, foot deformities correction, Cerebral palsy

Authors

First Name

Tarek

Last Name

Abdelaziz

MiddleName

Hassan

Affiliation

Orthopaedic Department, Faculty of medicine, Ain Shams University, Cairo, Egypt.

Email

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City

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Orcid

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First Name

Mohamed

Last Name

Al Sayed

MiddleName

Nabil

Affiliation

Orthopaedic Department, Faculty of medicine, Ain Shams University, Cairo, Egypt.

Email

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City

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Orcid

-

First Name

Amr

Last Name

Mohamed

MiddleName

Farouk

Affiliation

Orthopaedic Department, Faculty of medicine, Ain Shams University, Cairo, Egypt.

Email

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City

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Orcid

-

First Name

Ahmed

Last Name

Ali

MiddleName

Said

Affiliation

MD., Orthopaedic Department, Faculty of medicine, Ain Shams University, Cairo, Egypt.

Email

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City

-

Orcid

-

First Name

Mohamed

Last Name

Mahmoud

MiddleName

Nabil

Affiliation

M.Sc., Orthopedic Specialist, Ministry of Health/ International Medical Center, Egypt.

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-

City

-

Orcid

-

Volume

71

Article Issue

2

Related Issue

18820

Issue Date

2020-06-01

Receive Date

2020-11-26

Publish Date

2020-06-01

Page Start

385

Page End

397

Print ISSN

0002-2144

Online ISSN

2735-3540

Link

https://asmj.journals.ekb.eg/article_125648.html

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https://asmj.journals.ekb.eg/service?article_code=125648

Order

12

Type

Original Article

Type Code

1,311

Publication Type

Journal

Publication Title

Ain Shams Medical Journal

Publication Link

https://asmj.journals.ekb.eg/

MainTitle

CORRECTION OF PES PLANOVALGUS IN CEREBRAL PALSY: A SHORT TERM OUTCOME OF EXTRA-ARTICULAR SUBTALAR ARTHRODESIS

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Article

Created At

22 Jan 2023