[Restoration of the ability to walk through bilateral triple arthrodesis in marked spastic pes equinovarus].
A tendon transfer is the method of choice in easily reducible pes equinovarus. However, in long-time persisting deformities with spasms, a plantigrade position can not be maintained with these procedures. Therefore, we perform an additional bilateral triple arthrodesis in a patients with such bilateral deformities. A 55-year-old woman developed, within the scope of several surgical procedures on the cervical spine, marked bilateral pes equinovarus and flexion contractures of the knees. The patient's ambulation was limited to a wheelchair for 3 years. Then, in an interval of 1 year, we performed an unilateral soft tissue release, z-tenotomy of the Achilles tendon, triple arthrodesis with correction of the deformity, and posterior tibial tenden transfer. At follow-up 5 years after the second procedure, the 61-year-old patient was able to walk alone with two walking sticks. In the case described, the correction of a marked pes equinovarus with spasms, which was achieved by an extensive soft tissue release, could be stabilized through a triple arthrodesis in such way that the plantigrade position of the foot could be controlled through a posterior tibial tendon transfer.
Richter
M
M
Unfallchirurgische Klinik, Medizinische Hochschule, Hannover. Richter.Martinus@MH-Hannover.de
Zech
S
S
Geerling
J
J
Thermann
H
H
Krettek
C
C
D001174:Arthrodesis / Q000379:methods*; D003025:Clubfoot / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D011859:Radiography; D013035:Spasm / Q000150:complications / Q000601:surgery; D013709:Tendon Transfer; D013997:Time Factors; D016138:Walking