Gaytán-Fernández S, Chaidez P, García-Galicia A, Martínez-Asención P, Barragán-Hervella RG, Corpus-Mariscal E, Jiménez-Reyes M, Montiel-Jarquín AJ

Language: Spanish
References: 5
Page: 2-5
PDF size: 104.22 Kb.

ABSTRACT

Introduction: Childhood cerebral palsy, a non-progressive brain injury, occurs before, during or after delivery, with variable neurological damage from mild to disabling. The deformity in equine is treated conservatively at an early age, but when is surgical management indicated? Objective: Our goal was to determine the optimal age for surgical management of the equine foot in CCP patients. Material and methods: Retrospective study, in patients diagnosed with CCP (all types), treated surgically with open or percutaneous Achilles tendon elongation, assessed with external consultation notes, in patients aged 1-16 years, and average follow-up of 6 years, evaluating progress with relapse of deformity and gait with plantigrade support. Results: 55 patients, 74 equinus feet (29 in girls, 45 in boys) were analyzed with surgical treatment. Those treated before six years old presented relapses, with vulnerable period in 4-6 years. Monoplegia presented 100% relapses, and triplegia presented 0%. Open surgery presented 50% recurrence and percutaneous technique only 19%. Conclusion: In our institution, the optimal age is suggested in 6-12 years. Percutaneous technique over the open, should be preferred, and greater attention should be paid to monitoring monoplexy.

REFERENCES

1. Koman LA, Smith BP, Barron R. Recurrence of equinus foot deformity in cerebral palsy patients following surgery: a review. J South Orthop Assoc. 2003; 12: 125-33.

2. Rattey TE, Leahey L, Hyndman J, Brown DC, Gross M. Recurrence after Achilles tendon lengthening in cerebral palsy. J Pediatr Orthop. 1993; 13: 184-7.

3. Dietz FR, Albright JC, Dolan L. Medium term follow-up of Achilles tendon lengthening in the treatment of ankle equinus in cerebral palsy. Iowa Orthop J. 2006; 26: 27-32.

4. Boireau P, Laville JM. Percutaneous lengthening of the Achilles tendon in children with cerebral palsy. Technique and results. Rev Chir Orthop Reparatrice Appar Mot. 2002; 88: 705-9.

5. Greene WB. Cerebral palsy. Evaluation and management of equinus and equinovarus deformities. Foot Ankle Clin. 2000; 5: 265-80.