Paralytic congenital talipes equinovarus of unknown origin: A new entity. Multicenter study of 42 cases - 20/07/12

Doi : 10.1016/j.otsr.2012.02.008

A. Roux ^a,^⁎ , J.M. Laville ^a, V. Rampal ^b, R. Seringe ^b, F. Salmeron ^a
^a Pediatric Orthopaedic Surgery Department, F.-Guyon Regional Hospital Center, 97405 Saint-Denis, Reunion
^b Hôpital Saint-Vincent-de-Paul, université Paris Descartes, 82, avenue Denfert-Rochereau, 75014 Paris, France

Corresponding author. Tel.: +33 26 29 05 490; fax: +33 26 29 05 498.

conectar o crear una cuenta

Bienvenido a EM-consulte, la referencia de los profesionales de la salud.
Artículo gratuito.

Conéctese para beneficiarse!

En prensa. Pruebas corregidas por el autor. Disponible en línea desde el Friday 20 July 2012
This article has been published in an issue click here to access

Summary

Background

Paralysis of the lateral and/or anterior leg muscles can lead to relapse of treated talipes equinovarus.

Hypothesis

The muscle function impairment is due to isolated permanent paralysis, and early palliative tendon transfer may prevent recurrence of the deformity.

Material and methods

Forty-two cases of congenital talipes equinovarus that recurred after conservative therapy were reviewed after a mean follow-up of 10 years. In 39 cases, second-line surgery was performed (posteromedial release, n=33; and muscle transfer, n=26). Outcomes were evaluated clinically.

Results

Separating the cases into two groups, based on whether muscle transfer was performed, showed a statistically significant difference: muscle transfer intended to restore eversion and/or dorsal flexion of the foot was associated with significantly better functional outcomes.

Discussion

In addition to providing etiological insights, the identification of paralysis in patients with talipes equinovarus can influence treatment decisions, depending on the nature of the muscle deficiencies, with the goal of preventing recurrences. Early muscle transfer to restore eversion and/or dorsal flexion of the foot may provide the best functional outcomes by minimizing the need for soft-tissue release.