Cases reported "Equinus Deformity"

Filter by keywords:



Filtering documents. Please wait...

1/2. Long term course of the H reflex after selective tibial neurotomy.

    OBJECTIVES: This study was conducted to evaluate the long term clinical and electrophysiological outcome by recording the H reflex in a consecutive series of six patients treated by selective tibial neurotomy for spastic equinus foot. METHOD: The amplitudes of Hmax reflexes, Mmax responses, and Hmax:Mmax ratio were recorded in six patients with chronic lower limb spasticity, before and after surgery, at day 1 and 8 months and 24 months after selective tibial neurotomy. The passive range of movement, the stretch reflex score according to the Tardieu scale, the osteoarticular and tendon repercussions, and the quality of motor control of dorsiflexion were evaluated preoperatively and postoperatively. RESULTS: At the end of the study, all patients presented a reduction of equines. gait and Tardieu's score of spasticity had improved in all patients. Active dorsiflexion of the ankle was unchanged in four patients, but two improved by 5 degrees to 12 degrees. In five cases, fascicular resection of the superior nerve to soleus was, alone, sufficient to reduce spastic equinus foot, without recurrence, for a mean follow up of 28 months. Two patients were reoperated on, one for remaining spasticity related to an underestimated spasticity of the gastrocnemius muscles, and the other for painful claw toes. Hmax, Mmax, and Hmax:Mmax ratios were significantly lower the day after surgery. The reduction of Hmax and Hmax/Mmax ratio remained stable over time and was still statistically significant two years after the operation. However, the value of Mmax eight months postoperatively was no longer significantly different from the preoperative value. CONCLUSION: This study shows the long term efficacy of the selective tibial neurotomy as treatment of spastic equinus foot. Neurotomy confined to fibres supplying the soleus muscle is sufficient in most cases and acts by decreasing sensory afferents without significant long term motor denervation.
- - - - - - - - - -
ranking = 1
keywords = operative
(Clic here for more details about this article)

2/2. A new method for treating postburn talipes equinovarus.

    Postburn talipes equinovarus has long been a challenging problem for plastic surgeons, who usually replace the overlying scar in multistaged flap or tube transfer operations before lengthening the shortened achilles tendon. This always requires long hospitalization and causes much discomfort for the patient because of postural immobilization. In 1975, I designed a new and simple procedure by Z-lengthening the scar tissue and the achilles tendon as a whole in one stage. To date, the operative result in 10 cases has been excellent, without failure or recurrence.
- - - - - - - - - -
ranking = 0.25
keywords = operative
(Clic here for more details about this article)


Leave a message about 'Equinus Deformity'


We do not evaluate or guarantee the accuracy of any content in this site. Click here for the full disclaimer.