title: Paralytic congenital talipes equinovarus of unknown origin: A new entity. Multicenter study of 42 cases.
abstract: BACKGROUND
  Paralysis of the lateral and/or anterior leg muscles can lead to relapse of treated talipes equinovarus.
  
  
  OBJECTIVE
  The muscle function impairment is due to isolated permanent paralysis, and early palliative tendon transfer may prevent recurrence of the deformity.
  
  
  METHODS
  Forty-two cases of congenital talipes equinovarus that recurred after conservative therapy were reviewed after a mean follow-up of 10 years. In 39 cases, second-line surgery was performed (posteromedial release, n=33; and muscle transfer, n=26). Outcomes were evaluated clinically.
  
  
  RESULTS
  Separating the cases into two groups, based on whether muscle transfer was performed, showed a statistically significant difference: muscle transfer intended to restore eversion and/or dorsal flexion of the foot was associated with significantly better functional outcomes.
  
  
  CONCLUSIONS
  In addition to providing etiological insights, the identification of paralysis in patients with talipes equinovarus can influence treatment decisions, depending on the nature of the muscle deficiencies, with the goal of preventing recurrences. Early muscle transfer to restore eversion and/or dorsal flexion of the foot may provide the best functional outcomes by minimizing the need for soft-tissue release.
  
  
  METHODS
  IV, retrospective multicentre study.
authors: Pediatric Orthopaedic Surgery Department, F.-Guyon Regional Hospital Center, 97405 Saint-Denis, Reunion. chir.infantile.fguyon@chr-reunion.fr
authors: A
authors: A
authors: Roux
authors: J M
authors: JM
authors: Laville
authors: V
authors: V
authors: Rampal
authors: R
authors: R
authors: Seringe
authors: F
authors: F
authors: Salmeron
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003025:Clubfoot / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D033023:Foot Joints / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D008297:Male; D018482:Muscle, Skeletal / Q000637:transplantation*; D010243:Paralysis / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D016059:Range of Motion, Articular; D012008:Recurrence; D012189:Retrospective Studies; D013709:Tendon Transfer / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult