[Treatment of foot deformities in patients with Duchenne muscular dystrophy].
OBJECTIVE
There are different approaches to treat foot deformities in Duchenne muscular dystrophy. Some authors recommend conservative, others only surgical means. The purpose of this study was to compare the outcome of both non-surgical and surgical treatment.


METHODS
The records of 91 boys with DMD were retrospectively evaluated. The three treatment groups studied included group 1, those who had no surgery, group 2, those who had surgery to correct foot position, and group 3, those who had surgery to maintain ambulation and correct foot position.


RESULTS
Although conservative treatment of the feet in group 1 was carried out, severe equinovarus deformities developed. Surgery for the foot deformity including posterior tibial transfer was successful in 94 % at mean 8.5 years post-operative follow-up. The mean age of cessation of ambulation for those who had surgery to maintain ambulation was 11.2 years versus 10.3 years of those who did not have surgery (p < 0.05).


CONCLUSIONS
In patients with DMD, lower extremity surgery including posterior tibial tendon transfer can successfully correct and maintain foot position, as well as prolong ambulation. Early surgical treatment is required since conservative means can not prevent progression to severe equinovarus deformities.
Roposch
A
A
Universitätsklinik für Orthopädie Wien, Vienna. andreas.roposch@utoronto.ca
Scher
D M
DM
Mubarak
S
S
Kotz
R
R
D000203:Activities of Daily Living / Q000145:classification; D002648:Child; D003025:Clubfoot / Q000601:surgery; D005532:Foot Deformities, Congenital / Q000601:surgery*; D006801:Humans; D008297:Male; D020388:Muscular Dystrophy, Duchenne / Q000601:surgery*; D017063:Outcome Assessment, Health Care; D010043:Outcome and Process Assessment, Health Care; D026741:Physical Therapy Modalities; D011183:Postoperative Complications / Q000175:diagnosis / Q000503:physiopathology; D012189:Retrospective Studies; D013165:Splints; D013709:Tendon Transfer; D016138:Walking / Q000502:physiology; D016474:Weight-Bearing / Q000502:physiology