Double hindfoot arthrodesis technique for the treatment of severe equino-plano-valgus foot deformity in cerebral palsy: long-term results and radiological evaluation

J Pediatr Orthop B. 2019 May;28(3):235-241. doi: 10.1097/BPB.0000000000000616.

Abstract

The aim of this study was to evaluate the clinical and radiological results of a double arthrodesis technique for the treatment of equino-plano-valgus foot deformity in pediatric patients affected by cerebral palsy. A retrospective evaluation was performed on 175 feet surgically treated with a talonavicular and calcaneocuboid joint fusion technique. The average age at surgery was 14.7 years (range: 12-20 years). Visual analogue scale for pain score, Gross Motor Function Classification System scale, talonavicular angle, Costa-Bertani angle, and Kite's angle on standard weight bearing radiographs were evaluated preoperatively and postoperatively. The mean clinical follow-up was 62.4 months (range: 12-112 months). The mid Gross Motor Function Classification System scale value did not show a significant improvement in any of the subgroups considered. A significant improvement in the visual analogue scale for pain score value was evident 6 months after surgery. Radiological examination showed a statistically significant improvement in the talonavicular angle (average 7.4°) and the Costa-Bertani angle (average 128.5°). Complications occurred in 8.6% of cases. The described surgical technique is safe and efficacious, and could represent a useful option of treatment of equino-plano-valgus severe deformity in cerebral palsy patients older than 12 years of age.

MeSH terms

  • Adolescent
  • Arthrodesis / methods*
  • Cerebral Palsy / diagnostic imaging*
  • Cerebral Palsy / epidemiology
  • Cerebral Palsy / surgery*
  • Child
  • Equinus Deformity / diagnostic imaging
  • Equinus Deformity / epidemiology
  • Equinus Deformity / surgery
  • Female
  • Follow-Up Studies
  • Foot Deformities / diagnostic imaging*
  • Foot Deformities / epidemiology
  • Foot Deformities / surgery*
  • Humans
  • Male
  • Retrospective Studies
  • Severity of Illness Index*
  • Time Factors
  • Treatment Outcome
  • Young Adult