[Combined procedure for the treatment of ankle and foot deformities secondary to spina bifida].
OBJECTIVE
To study surgical strategies for ankle and foot deformities secondary to spina bifida and treatment methods for different types of deformities.


METHODS
From January 1990 and July 2009, 107 patients with ankle and foot deformities secondary to spina bifida were retrospectively analyzed. There were 44 males and 63 females, with an average age of 17.7 years (rangd from 1.3 to 52 years). Among the patients, 58 patients had double ankle deformities, 49 patients had unilateral deformities (22 cases on the left side, 27 cases on the right). Ninety-nine patients with equinus deformities were treated by achilles tendon lengthening and tendon transfering; 25 patients with talipes were treated by release of anterior tendon of ankle and tendon transfer; 17 patients with valgus and varus deformities were treated by tendon transfer and calcaneal osteotomy; 15 patients with flail deformities were managed treated by bone fusion between calcaneus and talus and shortening of achilles tendon; 9 patients with claw toe deformities were treated by bone fusion of interphalangeal joint or Ilizarovs distraction. AOFAS (American Orthopaedic Foot & Ankle Society) comprehensive scoring system was used to evaluate subjective pain and objective functional.


RESULTS
Seventy-nine (127 feet) of 107 patients were followed up, and the duration ranged from 48 to 180 months (averaged, 64 months). According to AOFAS scoring system, the results were rated as excellent in 89 feet, good in 26 feet, moderate in 9 feet and poor in 3 feet.


CONCLUSIONS
Treatment strategies for ankle-foot deformities mainly included four principles, deformity correction, muscular balance, joint stability and reservation of foot elasticity. Different combined procedure was applied for different foot deformities and received good therapeutic effects.
Department of Orthopaedic Surgery, Beijing Chuiyangliu Hospital, Beijing 100022, China. jsf0517@sina.com
Shao-Feng
SF
Jiao
Si-He
SH
Qin
Long-Xi
LX
Ren
Jian-Zhong
JZ
Ge
Hong-Fei
HF
Wu
Zhen-Jun
ZJ
Wang
Xue-Jian
XJ
Zheng
D000293:Adolescent; D000328:Adult; D000842:Ankle / Q000002:abnormalities / Q000601:surgery*; D000843:Ankle Joint / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D005260:Female; D005530:Foot Deformities / Q000209:etiology / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D016135:Spinal Dysraphism / Q000150:complications*; D055815:Young Adult