[Neurotomy of the tibial nerve for treatment of the talipes equinovarus].
OBJECTIVE
To explore indication and approaches of neurotomy of tibial nerve for the treatment of the talipes equinovarus and spastic paralysis.


METHODS
A total of 25 patients including 15 patients with cerebral paralysis and other 10 patients were diagnosed with clear etiology, spastic muscles with supplied nerves were analyzed in detail, neurotomy of the tibial nerve was performed under microscope, during operation, motor nerve was lovated with electronic stimuli and monitored with induced electromyography. The surgical results were analyzed.


RESULTS
A total of 36 of 37 (97%) neurotomy of the tibial nerve were improved with dorsum flex of ankle at 10 - 45 degree, and 22 of 24 (85%) talipes equinovarus improved clinically. Of 37 feet with surgery, 24 feet (65%) were in normal position and could touch ground completely, 9 feet (24%) had 10 degree with ground or could contact ground with external one third of the feet, 4 feet (11%) were abnormal. Of 25 patents, 21 (84%) had improvement of motor activity at discretion, 5 patients (20%) improved dramatically. All the 4 patients failed after the operation were cerebral paralysis, and were presumably related to disorders of spinal function, abnormal reflex and the disappearance of inhibitory reflex.


CONCLUSIONS
Neurotomy is an effective method to treat talipes equinovarus, and can improve the motor activity of low extremity.
Wang
Shi-jie
SJ
Department of Neurosurgery, Second Hospital of Tsinghua University, Beijing 100039, China.
Chen
Guo-qiang
GQ
Xiu
Bo
B
Zuo
Huan-cong
HC
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003025:Clubfoot / Q000601:surgery*; D004863:Equinus Deformity / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods; D013979:Tibial Nerve / Q000601:surgery*; D016896:Treatment Outcome