Parra-Téllez P, Hernández-González JL, López-Gavito E, Vázquez-Escamilla J

Language: Spanish
References: 11
Page: 97-102
PDF size: 257.42 Kb.

ABSTRACT

Hereditary sensorimotor neuropathy involves foot deformities such as varus and cavus foot and claw toes. Several surgical techniques have been described to treat Charcot-Marie-Tooth disease. Objective: To assess the clinical and functional result of «V» basal osteotomy of the central metatarsals with elevation of the first metatarsal, dorsal osteotomy plus closing osteotomy, and elevation of the fifth metatarsal in Charcot-Marie-Tooth patients during a five-year period. Material and methods: Prospective, randomized, longitudinal, observational and descriptive study conducted during a five-year period. Twenty-four patients met the inclusion criteria: 16 males and 8 females. Seven underwent the surgical procedure in the right foot, seven in the left, and 10 in both feet, for a total of 34 feet treated. Results: The Pearson correlation coefficient was -0.1 and T = 1.71. A statistically significant difference was seen between the variables, which meant that, in the six-month follow-up, surgical treatment had representative benefits. Conclusions: The study found a statistically significant value for function, pain and alignment in patients who underwent surgical treatment, compared with their status prior to surgery. It is therefore recommended to continue using this technique in all patients presenting with anterior cavus foot.

REFERENCES

1. Gregory P, Guyton GP: Current concepts review: orthopaedic aspects of Charcot-Marie-Tooth disease. Foot Ankle Intern. 2006; 27 (11): 1003-10.

2. Tooth HH: The peroneal type of progressive muscular atrophy. Cambridge University Dissertation, H.K. Lewis, London, 1886.

3. Dyck PJ, Chance P, Lebo R, Carney JA: Hereditary motor and sensory neuropathies. In: Dyck PJ, Thomas PK, Griffin JW, Low PA, Poduslo JF (eds.): Peripheral neuropathy. 3rd ed. W.B. Saunders, Philadelphia, 1993; 1094-136.

4. Reilly MM, Hanna MG: Genetic neuromuscular disease. J Neurol Neurosurg Psychiatry. 2002; 73(Suppl 2): II12-21.

5. Burns J, Redmond A, Ouvrier R, Crosbie J: Quantification of muscle strength and imbalance in neurogenic pes cavus, compared to health controls, using hand-held dynamometry. Foot Ankle Int. 2005; 26 (7): 540-4.

6. Skre H: Genetic and clinical aspects of Charcot-Marie-Tooth disease. Clin Genet. 1974; 6: 98-118.

7. Parra TP, et al: Manejo quirúrgico del pie cavo anterior en pacientes con Charcot-Marie-Tooth: Acta Ortopédica Mexicana. 2006; 20(2): 53-58.

8. Holmes JR, Hansen ST Jr: Foot and ankle manifestations of Charcot-Marie-Tooth disease. Foot Ankle. 1993; 14(8): 476-86.

9. Mann RA, Missirian J: Pathophysiology of Charcot-Marie-Tooth disease. Clin Orthop Relat Res. 1988; (234): 221-8.

10. Tachdjian MD: The neuromuscular system-deformities of the foot and ankle. In: Pediatric Orthopedics. 2nd ed. Philadelphia: WB Saunders, 1990; 1937-57.

11. Alexander IJ, Johnson KA: Assessment and management of pes cavus in charcot-Marie-Tooth disease. Clin Orthop. 1989; 246: 273-81.