[A Combination of Young's and Grice's Operation in Pes Planovalgus in Children with Cerebral Palsy.].
The authors describe a combination of operations according to Young and Grice, i.e. a combination of suspension of the os naviculare on the anterior tibial muscle for modelling the longitudinal arch of the foot with extraarticular talocalcanear arthrodesis, when dealing with neurogenic deformities of the sole in cerebral palsy in children, and evaluate the results of the operation. In general the authors draw attention to certain changes in the clinical picture of cerebral palsy, in particular a more frequent incidence of deformities of the soles which in recent years shifted from the original age of 6-8 years to the age 4-3 years. The combination of the mentioned operations improves the reposition of the soles and thus the general results of Grice's operation which is basic in deformities of the sole in surgery of celebral palsy. Young's operation can be performed in young children also separately. However, it does not produce permanent results without a secondary Grice's operation. It can be implemented in a second stage. Young's operation cannot be made unless there is a sufficiently strong anterior tibial muscle (at least grade 4 in the muscle test). Thus it cannot be performed in weak pareses. The achieved results (64,9 % excellent, 27,0 % good) fully justify the combination of the above operations. Key words: cerebral palsy (CP), extraarticular talocalcanear arthrodesis, Grice's operation, Young's operation, transposition of the tendon of the anterior tibial muscle across the os naviculare.
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Ortopedická klinika detí a dospelých 2. LF UK, Praha.
Schejbalová
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