Reconstructive Surgery and ADL of Spastic Talipes Equinovarus Associated with Hemiplegia

Abstract

There are lots of cases of walking disturbance caused by talipes equinovarus and hammer toe deformity which are associated with hemiplegia due to cerebral vascular disease. Deformities such as this kind of spastic paralysis are different from those of peripheral flaccid paralysis or of congenital secondary talipes equinovarus. Because these deformities of spastic paralysis become apparent in dynamic state, even if they are not recognized in static state.Therefore the main purpose of reconstructive surgery for these deformities is the restoration of the ability to support the body as well as the correction of the deformities and the removal of the contracture.We studied (1) the method of surgery and (2) the improvement in deformities, walking ability and ADL after surgery. The 36 patients were selected as those who had been observed for more than 6 months following reconstructive surgery for talipes equinovarus, out of 344 inpatients suffering from hemiplegia between August 1977 and December 1983. A remarkable improvement in ADL was observed after operation with respect to gait pattern and independency. The 12 patients who became free from equipment or were able to reduce the frequenciy of use of such equipment were mostly satisfied.