https://scholars.lib.ntu.edu.tw/handle/123456789/507494
標題: | Medial column stabilization improves the early result of calcaneal lengthening in children with cerebral palsy | 作者: | Huang, Che-Nan KUAN-WEN WU Huang, Shier-Chieg Kuo, Ken N. TING-MING WANG |
關鍵字: | calcaneal lengthening;cerebral palsy;medial column stabilization;pronated foot | 公開日期: | 五月-2013 | 卷: | 22 | 期: | 3 | 起(迄)頁: | 233 | 來源出版物: | Journal of Pediatric Orthopaedics Part B | 摘要: | Calcaneal lengthening is a popular surgical treatment for pronated foot deformity. The aim of this study is to assess the effectiveness of medial column stabilization in improving the results of calcaneal lengthening for pronated foot deformity in ambulatory children with cerebral palsy. Twenty-one consecutive (37 feet) children with cerebral palsy with pronated foot deformity who received calcaneal lengthening from 2004 to 2009 were reviewed. Talonavicular stabilizations were performed by either stapling alone or fusion depending on the children's age and correctability of midfoot deformity. Satisfaction rates were assessed using Mosca's radiographic, Mosca's clinical, and Yoo's clinical criteria. Talonavicular coverage angle was also measured. Results between groups with and without stabilization of the talonavicular joint were compared. Group 1 included 11 children (19 feet) who had no talonavicular stabilization. Group 2 included 10 children (18 feet) who had talonavicular fixation. Groups were further divided into subgroups A [Gross Motor Function Classification System (GMFCS)?II] and B (GMFCS?III). Factors including demography, geographical classification, functional status, and preoperative degree of deformity were similar between the two groups. After the operation, all four radiographic parameters improved significantly. The talonavicular coverage angle was better in group 2 than in group 1. Mosca's radiographic results were satisfactory in 73.68% of cases in group 1 and 100% in group 2; the difference was statistically significant (P=0.027). As for Mosca's clinical results, 63.16% in group 1 and 83.33% in group 2 achieved satisfactory results (P=0.156). On the basis of Yoo's criteria, the results were satisfactory in 57.89% of cases in group 1 and in 94.44% of cases in group 2 (P=0.012). Further analysis on the satisfaction rates between the subgroups showed similar results between the patients in subgroup 1A and 2A, and significantly better results in subgroup 2B than in subgroup 1B. Concurrent stabilization of the talonavicular joint is an effective method to improve clinical and radiographic results of calcaneal lengthening in children with cerebral palsy with pronated feet, and the effect is more significant in children with worse GMFCS levels. ? 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-84875797394&doi=10.1097%2fBPB.0b013e32835f1ede&partnerID=40&md5=911e563c745b9776bb325e54924ef597 https://scholars.lib.ntu.edu.tw/handle/123456789/507494 |
ISSN: | 1060-152X | DOI: | 10.1097/BPB.0b013e32835f1ede | SDG/關鍵字: | adolescent; article; calcaneus; cerebral palsy; child; clinical article; clinical effectiveness; female; foot malformation; foot radiography; foot surgery; functional status; Gross Motor Function Classification System; human; leg lengthening; male; mosca clinical criteria; mosca radiographic criteria; patient satisfaction; preoperative evaluation; preschool child; priority journal; radiological parameters; school child; surgical stapling; talonavicular coverage angle; talonavicular joint; talonavicular stabilization; yoo clinical criteria; Adolescent; Bone Lengthening; Calcaneus; Cerebral Palsy; Chi-Square Distribution; Child; Cohort Studies; Female; Follow-Up Studies; Foot Deformities, Congenital; Humans; Male; Range of Motion, Articular; Retrospective Studies; Risk Assessment; Statistics, Nonparametric; Talus; Tarsal Joints; Treatment Outcome |
顯示於: | 醫學系 |
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