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Calcaneal lengthening for the pes planovalgus foot deformity in children with cerebral palsy.

ABSTRACT: Purpose:The objective of this study was to evaluate the operative management of pes planovalgus deformity in ambulatory cerebral palsy (CP) children by calcaneal lengthening osteotomy described by Evans. Method:Fifteen children (10 girls and 5 boys) with average age 11 years 6 months (range, 8 years 4 months-14 years 6 months) with 22 feet with pes planovalgus (PPV) deformity were included in this study. Clinical evaluation was made according to Dogan's scale and graded as perfect, good, fair and poor. Preoperative and postoperative radiological assessment of anteroposterior talo-first metatarsal angle (AP-T1MT), anteroposterior talo-calcaneal angle (AP-TC), laterl Talo-first metatarsal angle (Lat. T1MT), lateral Talo-calcaneal angle (Lat. TC), and lateral Calcaneal pitch angle (Lat. CP) had been done for all feet. All feet were corrected with the modification of the calcaneal lengthening osteotomy described by Mosca. Result:Clinical results were perfect in 18 feet (82%), good in 2 feet (9%) and fair in 2 feet (9%). Radiological results showed improvement in 20 feet, while 2 feet showed no improvement. The improvement was significant in Lat. T1MT (P ‹ 0.001), AP-T1MT (P??0.05). Conclusion:The results of the present study showed that the procedure reliably relieves pain in PPV foot in CP children and proved effective in addressing all components of the deformity in both hindfoot and forefoot clinically and Radiologically.

SUBMITTER: Aboelenein AM

PROVIDER: S-EPMC7026583 | biostudies-literature | 2020 Mar-Apr

REPOSITORIES: biostudies-literature

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Calcaneal lengthening for the pes planovalgus foot deformity in children with cerebral palsy.

Aboelenein Aly Mohamed AM Fahmy Mohamed Lotfy ML Elbarbary Hassan Magdy HM Mohamed Abobakr Zein AZ Galal Sherif S

Journal of clinical orthopaedics and trauma 20180729 2

<h4>Purpose</h4>The objective of this study was to evaluate the operative management of pes planovalgus deformity in ambulatory cerebral palsy (CP) children by calcaneal lengthening osteotomy described by Evans.<h4>Method</h4>Fifteen children (10 girls and 5 boys) with average age 11 years 6 months (range, 8 years 4 months-14 years 6 months) with 22 feet with pes planovalgus (PPV) deformity were included in this study. Clinical evaluation was made according to Dogan's scale and graded as perfect ...[more]

PMID: 32099288

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Project description:Cerebral palsy is primarily an upper motor neuron disease that results in a spectrum of progressive movement disorders. Secondary to the neurological lesion, muscles from patients with cerebral palsy are often spastic and form debilitating contractures that limit range of motion and joint function. With no genetic component, the pathology of skeletal muscle in cerebral palsy is a response to aberrant neurological input in ways that are not fully understood. This study was designed to gain further understanding of the skeletal muscle response to cerebral palsy using microarrays and correlating the transcriptional data with functional measures. Hamstring biopsies from gracilis and semitendinosus muscles were obtained from a cohort of patients with cerebral palsy (n=10) and typically developing patients (n=10) undergoing surgery. Affymetrix HG-U133A 2.0 chips (n=40) were used and expression data was verified for 6 transcripts using quantitative real-time PCR, as well as for two genes not on the microarray. Chips were clustered based on their expression and those from patients with cerebral palsy clustered separately. Significant genes were determined conservatively based on the overlap of three summarization algorithms (n=1,398). Significantly altered genes were analyzed for over-representation among gene ontologies, transcription factors, pathways, microRNA and muscle specific networks. These results centered on an increase in extracellular matrix expression in cerebral palsy as well as a decrease in metabolism and ubiquitin ligase activity. The increase in extracellular matrix products was correlated with mechanical measures demonstrating the importance in disability. These data lay a framework for further studies and novel therapies. Skeletal muscle biopsies from both the gracilis and semitendinosus were obtained during surgery for 20 pediatric subjects for affymetrix microarray analysis. We obtained a group of 10 patients undergoing medial hamstring lengthening in the cerebral palsy group and 10 patients undergoing ACL reconstruction with hamstring autograft in the control group. This provided 40 microarrays in 4 groups to analyze the effect of cerebral palsy and also differences between muscles.

Dataset Information

Calcaneal lengthening for the pes planovalgus foot deformity in children with cerebral palsy.

Publications

Calcaneal lengthening for the pes planovalgus foot deformity in children with cerebral palsy.

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