دورية أكاديمية
أعرض في EDS

Surgical treatment of pes planovalgus in ambulatory children with cerebral palsy: Static and dynamic changes as characterized by multi-segment foot modeling, physical examination and radiographs.

التفاصيل البيبلوغرافية
العنوان: Surgical treatment of pes planovalgus in ambulatory children with cerebral palsy: Static and dynamic changes as characterized by multi-segment foot modeling, physical examination and radiographs.
المؤلفون: Nahm NJ; Department of Orthopaedic Surgery, Henry Ford Hospital, 2799 W Grand Blvd Detroit, MI, 48202, USA. Electronic address: nickolas.nahm@gmail.com., Sohrweide SS; Gillete Children's Specialty Healthcare, 200 University Ave East St. Paul, MN, 55101, USA. Electronic address: ssohrweide@gillettechildrens.com., Wervey RA; Gillete Children's Specialty Healthcare, 200 University Ave East St. Paul, MN, 55101, USA. Electronic address: rwervey@gillettechildrens.com., Schwartz MH; Gillete Children's Specialty Healthcare, 200 University Ave East St. Paul, MN, 55101, USA. Electronic address: mschwartz@gillettechildrens.com., Novacheck TF; Gillete Children's Specialty Healthcare, 200 University Ave East St. Paul, MN, 55101, USA. Electronic address: tnovacheck@gillettechildrens.com.
المصدر: Gait & posture [Gait Posture] 2020 Feb; Vol. 76, pp. 168-174. Date of Electronic Publication: 2019 Dec 12.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Elsevier Sciencem Country of Publication: England NLM ID: 9416830 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1879-2219 (Electronic) Linking ISSN: 09666362 NLM ISO Abbreviation: Gait Posture Subsets: MEDLINE
أسماء مطبوعة: Publication: <2007->: Oxford, UK : Elsevier Sciencem
Original Publication: Oxford, UK : Butterworth-Heinemann, c1993-
مواضيع طبية MeSH: Outpatients*, Cerebral Palsy/*complications , Flatfoot/*surgery , Gait/*physiology , Orthopedic Procedures/*methods , Physical Examination/*methods , Radiography/*methods, Adolescent ; Ankle Joint/diagnostic imaging ; Ankle Joint/surgery ; Calcaneus/diagnostic imaging ; Calcaneus/surgery ; Cerebral Palsy/physiopathology ; Female ; Flatfoot/diagnosis ; Flatfoot/etiology ; Follow-Up Studies ; Humans ; Male ; Treatment Outcome ; Walking/physiology
مستخلص: Background: This study employs multi-segment foot modeling (MSFM) to examine flatfoot reconstruction among ambulatory children with cerebral palsy (CP).
Research Question: Does flatfoot reconstruction improve MSFM measures, physical examination and radiographic variables for forefoot varus and midfoot collapse and associated multi-planar compensatory features?
Methods: MSFM was performed preoperatively and postoperatively in a cohort of ambulatory CP patients undergoing flatfoot reconstruction (surgical group, n = 24). A comparison group of non-surgical group of ambulatory CP patients with pes planovalgus (flatfoot) who did not undergo flatfoot reconstruction was also identified (n = 17). All patients in this comparison group underwent MSFM at two separate time points. Physical examination was performed and standing AP and lateral foot radiographs were obtained during each gait analysis session.
Results: Patients in the surgical group had improvement in their forefoot varus deformity, as documented on physical examination and kinematics in the STJN position of the foot and ankle, as well as in the compensatory hindfoot eversion and midfoot abduction during stance phase of gait. Furthermore, patients in the surgical group had improvement in midfoot collapse as identified kinematically by midfoot dorsiflexion, physical examination descriptors of midfoot position, and radiographic measures of calcaneal pitch and AP and lateral talar-first metatarsal angle. Patients in the non-surgical comparison group did not demonstrate these changes.
Significance: Improvements in foot motion after flatfoot reconstruction in ambulatory CP patients were identified by MSFM, physical examination measures, and radiographs. Patients in the surgical and non-surgical groups had similar pre-operative radiographic findings, suggesting that physical examination and MSFM data were important in the surgical decision making process. Finally, surgical intervention did not fully restore normal foot kinematic, physical examination, and radiographic parameters, which suggests that a different, perhaps more aggressive, surgical approach for flatfoot reconstruction is needed.
Competing Interests: Declaration of Competing Interest The authors declare no relevant conflicts of interest.
(Copyright © 2019 Elsevier B.V. All rights reserved.)
فهرسة مساهمة: Keywords: Cerebral palsy; Flatfoot; Multi-segment foot modeling; Pes planovalgus
تواريخ الأحداث: Date Created: 20191222 Date Completed: 20200928 Latest Revision: 20200928
رمز التحديث: 20221213
DOI: 10.1016/j.gaitpost.2019.12.004
PMID: 31862665
قاعدة البيانات: MEDLINE
الوصف
تدمد:1879-2219
DOI:10.1016/j.gaitpost.2019.12.004