DOI: https://doi.org/10.15674/0030-59872020280-88

The results of treatment of flexible pes planovalgus in children with cerebral palsy

Oleksandr Korolkov, Pavіеl Rakhman

Abstract


The treatment of mobile flat-foot deformity in children with cerebral palsy remains unresolved due to a variety of structural, functional and biomechanical changes in the foot, as well as the complex pathogenesis of formation. Objective: to present a differentiated approach and analysis of the results of surgical treatment of mobile flat-foot deformity in children with cerebral palsy. Methods: the results of surgical treatment of mobile flatfoot deformity were analyzed in 39 patients with cerebral palsy, who were divided into three groups. The choice of intervention method depended on the child's age, level of motor functions and clinical characteristics of the deformity. Sape and function disorders of the foot were evaluated according to AOFAS hindfoot scale. The author’s working clinical and radiological classification of this deformity was also applied. Results: surgical treatment of mobile flat-foot deformity in patients with cerebral palsy aged 7–11 years using soft tissue surgery is accompanied by a significant percentage of reccurence deformations (66.7 %). Additional application of the technique of subtalar arthroereisis can improve clinical and radiological results, but 80 % is accompanied by the development of chronic pain syndrome. In patients with cerebral palsy, older than 12 years, the effectiveness of surgical treatment of moderate and severe mobile flat-foot deformity using corrective lateral elongating osteotomy of the calcaneus bone and corrective osteotomy of the medial sphenoid bone has been clinically confirmed. Conclusions: the developed algorithm for differentiated choice of surgical treatment for mobile flat-foot deformity in children with cerebral palsy, depending on age, level of motor functions and clinical characteristics of the deformity, allowed us to choose between minimally invasive methods (subtalar arthroereisis, soft tissue surgery) and surgical interventions on the bones and joints of the foot (corrective calcaneus osteotomy, arthrodesis of the joints of the posterior and middle parts of the foot).

Keywords


cerebral palsy; flat-foot deformity of the feet; retrospective analysis of treatment methods and subtalar arthroereisis

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