Long-term results of triple arthrodesis in Charcot-Marie-Tooth disease.
We evaluated sixteen patients who had Charcot-Marie-Tooth disease and had had a total of thirty triple arthrodeses. The average age at the time of operation was fifteen years, and the average length of follow-up was twenty-one years. Of the thirty feet, the result in two (7 per cent) was rated excellent; in five (17 per cent), good; in nine (30 per cent), fair; and in fourteen (47 per cent), poor. Each of the fourteen feet that had a poor result had severe impairment of function and needed an orthosis. Six limbs had an arthrodesis of the ankle for degenerative joint disease. Progressive muscle imbalance resulted in recurrent cavovarus deformity in seven feet that initially had had satisfactory alignment. Degenerative changes of the ankle and joints of the mid-part of the foot were noted radiographically in twenty-three feet. The large number of unsatisfactory long-term results in these patients who had had a triple arthrodesis for deformity of the foot secondary to progressive peripheral neuropathy differs from those in earlier reports on patients who had poliomyelitis, who retained normal sensation and had a permanent, stable muscle imbalance. We believe that triple arthrodesis should be considered only as a salvage procedure in patients who have progressive peripheral neuropathy and should be limited to those who have severe, rigid deformity.
Wetmore
R S
RS
Department of Orthopaedic Surgery, Newington Children's Hospital.
Drennan
J C
JC
D000293:Adolescent; D000328:Adult; D001174:Arthrodesis / Q000379:methods*; D002607:Charcot-Marie-Tooth Disease / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D002648:Child; D005069:Evaluation Studies as Topic; D005260:Female; D005500:Follow-Up Studies; D005528:Foot / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D005684:Gait; D006801:Humans; D008297:Male; D009134:Muscular Atrophy, Spinal / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology; D011859:Radiography