TY - JOUR
T1 - Neglected neurogenic clubfoot treated with Achilles tendon lengthening using Z-plasty, total talectomy, and tibiocalcaneal arthrodesis
AU - Oesman, Ihsan
AU - Sari, Chintya Mutiara
N1 - Publisher Copyright:
© 2021 The Authors
PY - 2021/7
Y1 - 2021/7
N2 - Introduction: The most common foot and ankle deformity from injury to the nervous system is equinocavovarus. This deformity comprises of equinus, cavus, varus, and adduction of the forefoot which leads to pain and poor stability in stance phase of gait. Treatment for this condition is difficult regarding literature limitation of the neurogenic clubfoot management. We reported a 18-year-old female with neglected right neurogenic clubfoot treated with 2 stage deformity correction. Case report: A 18-year-old female presented with crooked right foot since birth. It caused pain, especially during walking and standing for a long time and resulted in occasional skin infection on the bottom of the foot. However, currently she could walk in limping gait without walking aid. The patient was born aterm 39 weeks through caesarean delivery due to severe preeclampsia. There was delayed development of walking at 2 years and 9 months. Previously, she had history of spina bifida and undergone surgery in 2001. Afterward, she underwent VP shunt surgery. Physical examination demonstrated cavus varus, tenderness of the right foot, and limited ankle motion. The patient was diagnosed with neglected right neurogenic clubfoot and underwent two stage deformity correction consisting of Achilles tendon lengthening using Z-plasty, total talectomy, and tibiocalcaneal arthrodesis followed by posteromedial release, tendon lengthening (Tibialis posterior, FDL, FDB) and plantar fascia release. Conclusions: Two stage deformity correction can be successful in patients with neglected neurogenic clubfoot. Further studies are required to investigate the safety and efficacy of such procedure in neurogenic clubfoot.
AB - Introduction: The most common foot and ankle deformity from injury to the nervous system is equinocavovarus. This deformity comprises of equinus, cavus, varus, and adduction of the forefoot which leads to pain and poor stability in stance phase of gait. Treatment for this condition is difficult regarding literature limitation of the neurogenic clubfoot management. We reported a 18-year-old female with neglected right neurogenic clubfoot treated with 2 stage deformity correction. Case report: A 18-year-old female presented with crooked right foot since birth. It caused pain, especially during walking and standing for a long time and resulted in occasional skin infection on the bottom of the foot. However, currently she could walk in limping gait without walking aid. The patient was born aterm 39 weeks through caesarean delivery due to severe preeclampsia. There was delayed development of walking at 2 years and 9 months. Previously, she had history of spina bifida and undergone surgery in 2001. Afterward, she underwent VP shunt surgery. Physical examination demonstrated cavus varus, tenderness of the right foot, and limited ankle motion. The patient was diagnosed with neglected right neurogenic clubfoot and underwent two stage deformity correction consisting of Achilles tendon lengthening using Z-plasty, total talectomy, and tibiocalcaneal arthrodesis followed by posteromedial release, tendon lengthening (Tibialis posterior, FDL, FDB) and plantar fascia release. Conclusions: Two stage deformity correction can be successful in patients with neglected neurogenic clubfoot. Further studies are required to investigate the safety and efficacy of such procedure in neurogenic clubfoot.
KW - Achilles tendon lengthening
KW - Neurogenic clubfoot
KW - Tibiocalcaneal arthrodesis
KW - Total talectomy
UR - http://www.scopus.com/inward/record.url?scp=85107734709&partnerID=8YFLogxK
U2 - 10.1016/j.ijscr.2021.106051
DO - 10.1016/j.ijscr.2021.106051
M3 - Article
AN - SCOPUS:85107734709
SN - 2210-2612
VL - 84
JO - International Journal of Surgery Case Reports
JF - International Journal of Surgery Case Reports
M1 - 106051
ER -