Συγκριτική μελέτη των επεμβάσεων εξωαρθρικής αρθρόδεσης του ταρσού και οστεοτομίας επιμήκυνσης πτέρνης σε παιδιά με σπαστική βλαισοπλατυποδία επί εδάφους εγκεφαλικής παράλυσης.

Doctoral Dissertation uoadl:1305568 764 Read counter

Unit:
Τομέας Χειρουργικής
Library of the School of Health Sciences
Deposit date:
2012-11-21
Year:
2012
Author:
Μάζης Γεώργιος
Dissertation committee:
Παναγιώτης Ν Σουκάκος (επιβλέπων), Αναστάσιος Δ Κανελλόπουλος, Παναγιώτης Ι Παπαγγελόπουλος.
Original Title:
Συγκριτική μελέτη των επεμβάσεων εξωαρθρικής αρθρόδεσης του ταρσού και οστεοτομίας επιμήκυνσης πτέρνης σε παιδιά με σπαστική βλαισοπλατυποδία επί εδάφους εγκεφαλικής παράλυσης.
Languages:
Greek
Summary:
Objective: The purpose of our study is to evaluate the results of two valid
surgical
techniques, extra-articular subtalar arthrodesis (Grice-Green) and calcaneal
lengthening osteotomy, used for the treatment of patients with spastic pes
planovalgus
deformity and cerebral palsy.
Material and Method: Our material consists of two groups of patients with
spastic
pes planovalgus deformity and cerebral palsy who underwent extra-articular
subtalar
arthrodesis, eleven children (16 feet), and calcaneal lengthening osteotomy, ten
children (16 feet). These patients were chosen to match in the type of spastic
disorder
and age. The results of their procedures were reviewed retrospectively. In
order to
evaluate the surgical outcome of the two procedures we compared seven
radiographic
parameters of each patient before surgery, after surgery and at the latest
follow-up. In
order to evaluate the changes in functional ability we used Gross Motor Function
Classification System, preoperatively and at the latest follow-up.
Results: The analysis for the anteroposterior talus-first metatarsal angle,
anteroposterior talocalcaneal angle, lateral talocalcaneal angle, Meary angle,
naviculocuboid overlap and talonavicular coverage angle revealed a statistically
significant difference between groups (p<0.05) with calcaneal lengthening
osteotomy
ranking lower than extra-articular subtalar arthrodesis (Grice-Green). The
analysis for
the calcaneal pitch angle revealed a statistically significant difference
between groups
(p=0.003) with extra-articular subtalar arthrodesis (Grice-Green) ranking lower
than
calcaneal lengthening osteotomy. The analysis for functional ability did not
show
statistically significant differences between groups (p>0.05).
Conclusions: Despite the obvious anatomical and biomechanical advantages of
calcaneal lengthening osteotomy, the extra-articular subtalar arthrodesis
(Grice234
Green) may be indicated in carefully selected patients with lower functional
ability
(non ambulators or household ambulators).
Keywords:
Spastic pes planovalgus deformity, Cerebral palsy, Extra-articular subtalar arthrodesis, Calcaneal lengthening osteotomy
Index:
No
Number of index pages:
0
Contains images:
Yes
Number of references:
134
Number of pages:
xxxvii, 257

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