TITLE

Long-Term Results of Reconstruction for Treatment of a Flexible Cavovarus Foot in Charcot-Marie-Tooth Disease

AUTHOR(S)
Ward, Christina M.; Dolan, Lori A.; Bennett, D. Lee; Morcuende, Jose A.; Cooper, Reginald R.
PUB. DATE
December 2008
SOURCE
Journal of Bone & Joint Surgery, American Volume;Dec2008, Vol. 90-A Issue 12, p2631
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: Cavovarus foot deformity is common in patients with Charcot-Marie-Tooth disease. Multiple surgical reconstructive procedures have been described, but few authors have reported long-term results. The purpose of this study was to evaluate the long-term results of an algorithmic approach to reconstruction for the treatment of a cavovarus foot in these patients. Methods: We evaluated twenty-five consecutive patients with Charcot-Marie-Tooth disease and cavovarus foot deformity (forty-one feet) who had undergone, between 1970 and 1994, a reconstruction consisting of dorsiflexion osteotomy of the first metatarsal, transfer of the peroneus longus to the peroneus brevis, plantar fascia release, transfer of the extensor hallucis longus to the neck of the first metatarsal, and in selected cases transfer of the tibialis anteriortendon to the lateral cuneiform. Each patient completed standardized outcome questionnaires (the Short Form-36 [SF-36] and Foot Function Index [FFI]). Radiographs were evaluated to assess alignment and degenerative arthritis, and gait analysis was performed. The mean age at the time of follow-up was 41.5 years, and the mean duration of follow-up was 26.1 years. Results: Correction of the cavus deformity was well maintained, although most patients had some recurrence of hindfoot varus as seen on radiographic examination. The patients had a lower mean SF-36 physical component score than age-matched norms, and the women had a lower mean SF-36 physical component score than the men, although this difference was not significant. Smokers had lower mean SF-36 scores and significantly higher mean FFI pain, disability, and activity limitation subscores (p < 0.0001). Seven patients (eight feet) underwent a total of eleven subsequent foot or ankle operations, but no patient required a triple arthrodesis. Moderate-to-severe osteoarthritis was observed in eleven feet. With the numbers studied, the age at surgery, age at the time of follow-up, and body mass index were not noted to have a significant correlation with the SF-36 or FFI scores. Conclusions: Use of the described soft-tissue procedures and first metatarsal osteotomy to correct cavovarus foot deformity results in lower rates of degenerative changes and reoperations as compared with those reported at the time of long-term follow-up of patients treated with triple arthrodesis. Level of Evidence: Therapeutic Level IV. See Instructions to Authors for a complete description of levels of evidence.
ACCESSION #
36346491

 

Related Articles

  • Charcot-Marie-Tooth and pain: correlations with neurophysiological, clinical, and disability findings. Padua, Luca; Cavallaro, Tiziana; Pareyson, Davide; Quattrone, Aldo; Vita, Giuseppe; Schenone, Angelo // Neurological Sciences;Jun2008, Vol. 29 Issue 3, p193 

    Pain is not considered a relevant symptom in Charcot-Marie-Tooth (CMT) patients and no studies have comprehensively assessed it. We performed a multidimensional assessment in 211 consecutive CMT patients to evaluate the clinical features, quality of life (QoL) and disability. For QoL we used the...

  • Clinical digest. Trial proves apremilast is effective long-term treatment for psoriasis.  // Nursing Standard;10/10/2012, Vol. 27 Issue 6, p14 

    The article discusses research in the article "Efficacy of Apremilast in the Treatment of Moderate to Severe Psoriasis: A Randomised Controlled Trial" by K. Papp et al. which found that the drug apremilast is effective for the long term treatment of psoriasis.

  • Clinical digest. Evidence supports wider use of tranexamic acid in traumatic bleeding.  // Nursing Standard;10/10/2012, Vol. 27 Issue 6, p15 

    The article discusses research in the article "Effect of Tranexamic Acid on Mortality in Patients With Traumatic Bleeding: Prespecified Analysis of Data From Randomised Controlled Trial" by I. Roberts et al. which found that tranexamic acid is safe and effective in treating traumatic bleeding.

  • Clinical digest. Most people treated for schizophrenia experience no lasting improvements in health.  // Nursing Standard;4/18/2012, Vol. 26 Issue 33, p14 

    The article discusses research which was published in the article "Sustained Favourable Long-Term Outcome in the Treatment of Schizophrenia: A 3-Year Prospective Observational Study" by G Cuyun Carter et al. and found that most people treated for schizophrenia experience no lasting improvements...

  • PERSPECTIVE. Hee Kit Wong // Orthopedics Today;Jul2011, Vol. 31 Issue 7, p26 

    The author comments on the study by Miyako Suzuki wherein Suzuki found that, in determining whether using local bone graft is as effective as iliac crest bone graft in case of L4 degenerative spondylolisthesis, there are fusion rates of 90% and 85%, respectively, in single-level instrumented cases.

  • Clinical digest. Surgery for epilepsy can enhance patients' overall long-term quality of life.  // Nursing Standard;3/7/2012, Vol. 26 Issue 27, p18 

    The article discusses research which was reported in the article "Impact of Epilepsy Surgery on Seizure Control and Quality of Life: A 26-Year Follow-Up Study" by H. S. Mohammed et al and found that surgery for epilepsy can enhance patients’ overall long-term quality of life.

  • Emergency Brake Response Time After First Metatarsal Osteotomy. Holt, G.; Kay, M.; McGrory, R.; Kumar, C. S. // Journal of Bone & Joint Surgery, American Volume;Aug2008, Vol. 90-A Issue 8, p1660 

    Background: There is sparse information upon which to recommend a return to activity after foot surgery. The purpose of this study was to determine whether six weeks is sufficient time for the emergency brake response time to return to preoperative levels after a first metatarsal osteotomy for...

  • Cementing Techniques for Hip Resurfacing Arthroplasty: Development of a Laboratory Model. Bitsch, Rudi G.; Loidolt, Travis; Heisel, Christian; Schmalzried, Thomas P. // Journal of Bone & Joint Surgery, American Volume;Aug2008 Supplement 3, Vol. 90-A, p102 

    Background: Hip resurfacing is extremely technique-sensitive, yet scientific investigations into cementing techniques are lacking. In this study, we tested open-cell, reticulated, carbon-foam materials in comparison with paired human femoral heads to validate a laboratory cementing model for...

  • Comparison of Arthrodesis and Metallic Hemiarthroplasty of the Hallux Metatarsophalangeal Joint. Raikin, Steven M.; Ahmad, Jamal // Journal of Bone & Joint Surgery, American Volume;Oct2008 Supplement 2, Vol. 90-A, p171 

    BACKGROUND: Currently, arthrodesis is the most commonly performed surgical procedure for the treatment of severe arthritis of the first metatarsophalangeal joint. The objective of this study was to compare the long-term clinical and radiographic outcomes of a metallic hemiarthroplasty with those...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics