Arthrodesing surgeries in children above 10 years of age with feet deformities of various etiologies

Вавилов М.А., Бландинский В.Ф., Громов И.В., Баушев М.А., Платонов С.М.

Abstract


Introduction. Deformities are the most common malformations of the feet and they reach 35.8 %.
Purpose. To demonstrate the possibility of arthrodesing surgeries for different feet deformities in children above 10 years of age.
Materials and Methods. The analysis of the results of treating severe feet deformities in the Regional Clinical Hospital of Yaroslavl since 1999 using internal and external structures (38 children, 47 feet) served as the study material. Mostly clubfoot (19 feet – 40.4%) was the cause of performing such difficult surgeries in adolescents. These children underwent on the average 2, 3 unsuccessful surgeries in their history. Children with central nervous system (CNS) pathology (cerebral palsy, fixed spinal cord, consequences of craniocerebral injury) underwent 17 arthrodesing surgeries of feet. The interventions in 7 feet performed for the consequences of Charcot-Marie progressing muscular atrophy and those in two feet – for conservatively incurable tarsal coalitions. The use of screws after performing arthrodesing surgeries allows loading the operated limb significantly faster comparing with wire- and device-related fixation.
Results. The introduction of new little-invasive techniques for treatment (that of I. Ponseti for clubfoot and that of M. Dobbs for vertical talus) in the routine practice of pediatric orthopedists resulted in a sharp reduction in the number of releases that should decrease the need for large arthrodesing surgeries in future. But at the moment arthrodesis procedures in adolescents revealed as a reliable option for surgical correction of feet deformities in severe and advanced cases, as well as they allowed correcting feet deformities in the mentioned age-related group in 97.9 % of cases.
Conclusion. Arthrodesing surgeries for severe deformities are the method of choice in treatment of recurrent and conservatively incurable feet deformities.

Keywords


arthrodesis, arthrogryposis, clubfoot, flatfoot, recurrence, foot

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