title: [Partial blocking of the tibial nerve with phenol as treatment of gait disorders due to pes equinus in central paralysis].
abstract: Partial chemical neurolysis by means of a peripheral nerve block induced with a phenol solution can result in decreasing local muscle hypertonia of central origin. In case of a walking disability resulting from a spastic or dystonic equinovarus position of the ankle the phenol block of the tibial nerve may be a valuable treatment that improves walking ability. The technique of the procedure is explained. A phenol block is induced only after a favourable result of a trial block with a local anaesthetic. In the group of 19 patients who underwent tibial nerve block given by the author in the period 1987-1989 there appears to exist a correlation between the functional results and the extent to which the patient had been active in walking prior to the nerve block. A group of 6 'sitters' and 'hardly walking' patients had poor to moderate results, a group of 13 'walkers' had moderate, good and excellent results. The difference in functional outcome is ascribed by the author to a better possibility to actually utilise a muscular balance improved by the phenol block. In the early--recovery--phase of stroke rehabilitation a phenol block of the tibial nerve may well be useful in cases with equinovarus position of the ankle which interferes with therapeutic exercise and functional progress.
authors.affiliation: Revalidatiecentrum St. Maartenskliniek, Nijmegen.
authors.forename: M J
authors.initials: MJ
authors.lastname: Wichers
mesh_terms: D000368:Aged; D002648:Child; D005260:Female; D005531:Foot Deformities, Acquired / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D005684:Gait; D006429:Hemiplegia / Q000150:complications; D006801:Humans; D008297:Male; D009128:Muscle Spasticity / Q000628:therapy; D009407:Nerve Block; D010636:Phenols / Q000627:therapeutic use*; D013979:Tibial Nerve / Q000187:drug effects*
chemical_list: D010636:Phenols
vernacular_title: Partiële blokkade van de nervus tibialis met fenol als behandeling van loopstoornissen door een spitsvoet bij centrale parese.