Abstract
Introduction. Pes calcaneus deformity is a rare pathology in children, which is due to the defect of long flexors of the foot caused by various neurological diseases. The treatment choice is based on the patient’s age, parameters of neuromuscular disorders, and degree of foot deformation.
 Aim. This study aimed to analyze the results of operative correction of рes calcaneus deformities in children.
 Material and methods. This analysis of surgical treatment involved 13 patients (21 feet) aged 1.5 to 15 years with рes calcaneus deformities. The different approaches and methods of surgical treatment were described. Children up to 12 years old were released joints of the foot with the elimination of deformation and tendon-muscle transposition with the transfer of functionally preserved muscles in the position of fallen muscle antagonists. Children over 12 years old underwent surgery on the bone apparatus of foot: three-articular arthrodesis or corrective osteotomy of the calcaneus, some cases were supplemented with tendon-muscle transpositions.
 Results. Treatment results were evaluated based on the radiometric parameters on the system of AOFAS. All treated patients showed improvement in foot stability with reduced deformation; АОFAS at an average of 91.14 points was observed.
 Conclusion. A record of all causes and strain components with a graded approach eliminates the pes calcaneus deformity in the long-term, despite persistent violation of neuromuscular conduction.
Highlights
Pes calcaneus deformity is a rare pathology in children, which is due to the defect of long flexors of the foot caused by various neurological diseases
This study aimed to analyze the results of operative correction of рes calcaneus deformities in children
Central Research Institute of Traumatology and Orthopedics named after N.N. Priorov, Moscow, Russia
Summary
ФГБУ «Национальный медицинский исследовательский центр травматологии и ортопедии им. Н.Н. Выбор метода оперативной коррекции основан на возрасте пациента, параметрах нарушений нейромышечного аппарата, а также степени деформации стопы. Проведен анализ оперативного лечения 13 пациентов (21 стопа) в возрасте от 1,5 до 15 лет с пяточной деформацией стопы. Описан дифференцированный подход и методы хирургического лечения. Детям до 12 лет был выполнен релиз суставов стопы, в том числе устранение деформации и сухожильно-мышечная транспозиция с переносом функционально сохранных мышц в позицию выпавших мышц-антагонистов. Детям старше 12 лет проводили операции на костном аппарате стопы: трехсуставной артродез или корригирующие остеотомии пяточной кости, дополненные сухожильно-мышечными транспозициями. Результаты лечения оценивали на основании рентгенометрических параметров и количества баллов по системе AOFAS. Учет всех причин и компонентов деформации и дифференцированный подход позволяют устранить пяточную стопу на долгосрочный период, несмотря на сохраняющиеся нарушения нейромышечной проводимости. Ключевые слова: пяточная стопа; нейрогенные деформации стопы; сухожильно-мышечные транспозиции; трехсуставной артродез; остеотомия пяточной кости; дети
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