TARSAL COALITIONS IN CHILDREN WITH CEREBRAL PALSY: CLINICAL OBSERVATION AND TREATMENT STRATEGY

Tarsal coalition is a congenital anomaly of the foot, characterized by later appearance of the clinical and radiological signs, which become obvious in adolescents. Tarsal coalitions in children with cerebral palsy can lead to diagnostic confusion, as well as to complicate natural course of foot deformity and surgical treatment. The paper presents first experience with the systematized data for tarsal coalitions in children with cerebral palsy. Among 157 children operated for foot deformities this anomaly was identified in 4 patients (incidence - 2,5 % in our series). Clinical and radiological descriptions, surgical management, including complications, are presented for these cases, which demonstrate significance of tarsal coalitions for diagnostics, surgical management and prognosis. Information and caution, regarding tarsal coalitions in children with cerebral palsy, who undergo surgical treatment for foot deformities, as well as advanced methods of diagnostics (magnetic resonance and computed tomography), are required in order to avoid preventable complications.

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Surgical treatment of pes planovalgus in ambulatory children with cerebral palsy: effect on gait as characterized by multi-segment foot motion analysis and foot deformity

Developmental Medicine & Child Neurology ◽

10.1111/dmcn.97_14017 ◽

2018 ◽

Vol 60 ◽

pp. 63-63

Keyword(s):

Cerebral Palsy ◽

Surgical Treatment ◽

Motion Analysis ◽

Pes Planovalgus ◽

Foot Deformity ◽

Foot Motion ◽

Children With Cerebral Palsy

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Selective dorsal rhizotomy opportunities with foot deformitiesin children with cerebral palsy

Pediatric Traumatology Orthopaedics and Reconstructive Surgery ◽

10.17816/ptors3122-26 ◽

2015 ◽

Vol 3 (1) ◽

pp. 22-26

Author(s):

Vladimir Markovich Kenis ◽

Stanislav Vyacheslavovich Ivanov ◽

Tatiana Ilinichna Kiseleva

Keyword(s):

Cerebral Palsy ◽

Foot Deformities ◽

Total Thickness ◽

Foot Deformity ◽

Selective Dorsal Rhizotomy ◽

Dorsal Rhizotomy ◽

Management Protocol ◽

Children With Cerebral Palsy ◽

Foot Posture ◽

Calf Muscles

Foot deformities are the most common orthopedic condition in children with cerebral palsy. The aim of the study was to evaluate the influence of selective dorsal rhizotomy (SDR) on foot deformities in children with cerebral palsy. The results were assessed clinically by measurement of changes in muscle spaticity and foot posture. Percentage of resection of dorsal rootlets was from 40 to 90 % of total thickness. The degree of tone reduction had a tendency to be more pronounced in the more proximal muscles and was minimal in calf muscles. Nevertheless, foot posture improved more significantly. That can be explained by generalimprovement of pathological posture at the level of more proximal joints. Thus, SDR has insignificant direct effect on spastic foot deformity and can not be recommended as a basic method of treatment even in pure spasticity. However, SDR should be considered as a part of multidisciplinary management protocol if foot deformity reflects more complex postural disturbance due to generalized spasticity.

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Calcaneal Lengthening for Planovalgus Deformity in Children with Cerebral Palsy

Foot & Ankle International ◽

10.3113/fai-2009-0398 ◽

2009 ◽

Vol 30 (5) ◽

pp. 398-404 ◽

Cited By ~ 19

Author(s):

Volker Ettl ◽

Nicole Wollmerstedt ◽

Stephan Kirschner ◽

Robert Morrison ◽

Eva Pasold ◽

...

Keyword(s):

Cerebral Palsy ◽

Relapse Rate ◽

Clinical Result ◽

Foot Deformities ◽

Radiological Outcome ◽

Foot Deformity ◽

High Relapse Rate ◽

Children With Cerebral Palsy ◽

Clinical And Radiological Outcome ◽

Calcaneal Lengthening

Background: In children with cerebral palsy, planovalgus deformity of the foot is common. The aim of this study was to evaluate the outcome of calcaneal lengthening for the treatment of planovalgus foot deformity in children with cerebral palsy. Materials and Methods: We reviewed 19 children (28 feet) treated between 1996 and 2004 in our institution. There were 14 ambulating (19 feet) and 5 nonambulating children (9 feet). The average age of the children at time of surgery was 8.6 years. Followup averaged 4.3 years. Results: We found satisfactory results in 75% of the feet clinically and in 79% radiologically according to Mosca's criteria. We saw no overcorrection but a relapse of the deformity in seven cases. There were six unsatisfactory radiological results, two (out of 19) in the ambulating and four (out of nine) in the nonambulating group. Ambulating children had a significantly better clinical and radiological outcome than nonambulating children ( p = 0.042). A significant correlation was found between Ankle-hindfoot Score and clinical result according to Mosca's criteria ( p = 0.001). Conclusion: In ambulatory children with cerebral palsy calcaneal lengthening is an effective procedure for the correction of mild to moderate planovalgus foot deformities. In nonambulatory children with severe plano-valgus deformities of the foot, calcaneal lengthening cannot be recommended because of the high relapse rate in these patients.

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Clinical observation on spleen-invigorating and qi-benefiting pediatric massage for treating recurrent respiratory tract infection in children with cerebral palsy due to qi deficiency of spleen and lung

Journal of Acupuncture and Tuina Science ◽

10.1007/s11726-021-1233-0 ◽

2021 ◽

Vol 19 (2) ◽

pp. 110-116

Author(s):

Xie Jie-shan ◽

Li Yu-xiu ◽

Yan Xiao-lan ◽

Xun Jing-ping ◽

Jin Bing-xu

Keyword(s):

Cerebral Palsy ◽

Tract Infection ◽

Respiratory Tract ◽

Respiratory Tract Infection ◽

Clinical Observation ◽

Recurrent Respiratory Tract Infection ◽

Children With Cerebral Palsy

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Vertical gastric plication versus Nissen fundoplication in the treatment of gastroesophageal reflux in children with cerebral palsy

Sao Paulo Medical Journal ◽

10.1590/s1516-31802007000100004 ◽

2007 ◽

Vol 125 (1) ◽

pp. 15-21 ◽

Cited By ~ 9

Author(s):

Antonio Paulo Durante ◽

Sergio Tomaz Schettini ◽

Djalma José Fagundes

Keyword(s):

Cerebral Palsy ◽

Surgical Treatment ◽

Gastroesophageal Reflux ◽

Nissen Fundoplication ◽

Length Of Hospital Stay ◽

Signs And Symptoms ◽

High Morbidity ◽

Gastric Plication ◽

Esophageal Ph ◽

Children With Cerebral Palsy

CONTEXT AND OBJECTIVE: Association between neurological lesions and gastroesophageal reflux disease (GERD) in children is very common. When surgical treatment is indicated, the consensus favors the fundoplication technique recommended by Nissen, despite its high morbidity and relapse rates. Vertical gastric plication is a procedure that may have advantages over Nissen fundoplication, since it is less aggressive and more adequately meets anatomical principles. The authors proposed to compare the results from the Nissen and vertical gastric plication techniques. DESIGN AND SETTING: Randomized prospective study within the Postgraduate Surgery and Experimentation Program of Unifesp-EPM, at Hospital do Servidor Público Estadual (IAMSPE) and Hospital Municipal Infantil Menino Jesus. METHODS: Fourteen consecutive children with cerebral palsy attended between November 2003 and July 2004 were randomized into two groups for surgical treatment of GERD: NF, Nissen fundoplication (n = 7); and VGP, vertical gastric plication (n = 7). These were clinically assessed by scoring for signs and symptoms, evaluation of esophageal pH measurements, duration of the operation, intra and postoperative complications, mortality and length of hospital stay. RESULTS: The mean follow-up was 5.2 months; symptoms were reduced by 42.8% (NF) (p = 0.001) and 57.1% (VGP) (p = 0.006). The Boix-Ochoa score was favorable for both groups: NF (p < 0.001) and VGP (p < 0.042). The overall mortality was 14.28% in both groups and was due to causes unrelated to the surgical treatment. CONCLUSION: The two operative procedures were shown to be efficient and efficacious for the treatment of GERD in neuropathic patients, over the study period.

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