Parra TP, López GE, Vázquez EJ, García AA

Language: Spanish
References: 18
Page: 53-58
PDF size: 154.78 Kb.

ABSTRACT

Objective. To present the results of extra-articular surgery that corrects hammertoes and modifies weight bearing at the forefoot in patients with Charcot-Marie-Tooth. Material and methods. A longitudinal, prospective, descriptive, non-comparative study was carried out from October 2003 to December 2004 in patients with cavus midfoot. A total of 15 patients were enrolled, 4 females and 11 males; 23 feet, mean age was 18 years. Patients over age 35 and those with idiopathic cavus foot were excluded. Results. Follow-up at one year was performed using the Maryland scale, the AOFAS scale and the VAS, comparing the preoperative and postoperative scores, and the Wilcoxon sign as a comparative statistical test; complications occurred in 4 patients. Discussion. Results were similar to those reported by international studies and showed that osteotomy of metatarsal bases 2nd to 4th and dorsal osteotomy of the first metatarsal base help reduce the load placed on the forefoot and correct the cavus foot and the hammer toes. Conclusions. Surgery should focus mainly on the deformity and minimize complications through the proper selection of the surgical procedure to correct each of the components of the foot with Charcot-Marie-Tooth disease.

REFERENCES

1. Holmes JR, Hansen ST: Manifestations of Charcot-Marie-Tooth disease. Foot and Ankle 1993; 14(8): 476-486.

2. Olney B: Treatment of the cavus foot deformity in the pediatric patient with Charcot-Marie-Tooth. Foot and Ankle Clin 2000; 5(2): 305-315

3. Viladot A: Quince lecciones de patología del antepié. 4ta edición. Barcelona Springer. 2002: 50-94.

4. Guyton GP, Mann RA: The pathogenesis and surgical management of foot deformity in Charcot-Marie-Tooth disease. Foot Ankle Clin 2000; 5(2): 317-326.

5. Schend RM, Drennan JC: Cavus foot deformity in children. J Am Acad Orthop Surg 2003; 11(3): 200-211.

6. Mc Cluskey WP, Lovell WW: The cavovarus foot deformity. Etiology and management. Clin Orthop 1989; (247): 27-37.

7. Giannini S, Ceccarelli F: Surgical treatment of adult idiopathic cavus foot with plantar fasciotomy, naviculocuneiform arthrodesis and cuboid osteotomy. Journal Bone Joint Surg Am 2002: 84(Suppl 2): 562-569.

8. Guettler FPT: Idiopathic cavovarus and lateral instability: recognition and treatment implication relating to ankle arthritis. Foot Ankle Int 2002; 23(11): 1031-1037.

9. Núñez SM: Técnicas quirúrgicas en cirugía del pie. Ed. Masson. 2003: 167-169.

10. Sammarco GJT: Combined calcaneal and metatarsal osteotomies for the treatment of cavus foot. Foot and Ankle Clin 2001; (3): 533-543.

11. Bell Ch: Archives of disease in childhood. 1998; 78(4): 296-300.

12. Cassis N. Enfermedad de Charcot-Marie-Tooth. Manifestaciones clínicas y su tratamiento ortopédico en 21 pacientes. Rev Mex Ortop Traum 1997; 11(1): 10-13.

13. Mann DC, Hsu JD: Triple arthrodesis in the treatment of fixe cavovarus deformity in adolescent patients with Charcot-Marie-Tooth disease. Foot Ankle 1992; 13(1): 1-6.

14. Jahss MH: Evaluation of the cavus foot for orthopedic treatment. Clin Orthop 1983; (181): 52-63.

15. Wetmore RS: Long term results of triple arthrodesis in Charcot-Marie-Tooth disease. Journal Bone Joint Surgery 1989; 71-A(3).

16. Watanabe RS: Metatarsal osteotomy for the cavus foot. Clin Orthop 1990; (252): 217-30.

17. Alexander IJ, Johnson KA. Assessment and management of pes cavus in Charcot-Marie-Tooth disease. Clin Orthop 1989; (246): 273-281.

18. Sammarco GJ, Taylor R: Cavovarus foot treated with combined calcaneus and metatarsal osteotomies. Foot Ankle Int 2001; 22(1): 19-30.