Аналіз ефективності методів корекції пронаційних деформацій стоп у дітей з дитячим церебральним паралічем

Abstract

Pronation deformities of the feet are one of the most common childhood deformities requiring surgical treatment. For correction subtalar arthroereisis and subtalar arthrodesis according to Grice are used. The use of these methods in combination with the transposition of the gastrocnemius muscle is promising. Purpose - тo study the effectiveness of subtalar arthroereisis and subtalar arthrodesis according to Grice in combination with transposition of the gastrocnemius muscle in the correction of pronation deformity of the feet in children with cerebral palsy. Materials and methods. The results of treatment of 40 patients aged 7 to 16 years with pronation deformity of the feet were analyzed. Patients were divided into 2 groups. The main group (25 patients) was divided into 2 subgroups depending on the method of surgical treatment: the subgroup A - 10 patients who underwent subtalar arthroereisis with transposition of the tendon of the short peroneal muscle; the subgroup B - 15 patients who underwent subtalar arthrodesis according to Grice with transposition of the tendon of the short peroneal muscle. The control group included 15 patients who underwent subtalar arthrodesis according to Grice. Clinical and radiological methods were used to examine patients. Numerical data were compared between groups and processed statistically with the determination of M±m and the coefficient of reliability by Student’s t-test. The level of probability was set at p<0.05. Results. The advantage of subtalar arthroereisis and subtalar arthrodesis according to Grice in combination with transposition of the gastrocnemius muscle is the elimination of its pronation pathological effect on the foot, increased supination effect of the posterior tibialis muscle, as well as reduced compression on the autoimplant when performing subtalar arthrodesis according to Grice. Conclusions. The effectiveness of peroneal tendon transposition in combination with subtalar arthroereisis or arthrodesis in the correction of pronation deformity of the feet in children with cerebral palsy has been proven, which allows improving clinical and radiological parameters after treatment. The study was conducted in accordance with the principles of the Declaration of Helsinki. The study protocol was approved by the local ethics committees of all institutions participating in the study. Informed consent was obtained from the patients. No conflict of interests was declared by the authors.