Document Detail

Spastic equinus foot: multicenter study of the long-term results of tibial neurotomy.
MedLine Citation:
PMID:  15509319     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Tibial neurotomy is a surgical technique widely used for the treatment of spastic equinus foot, but it has rarely been evaluated. The primary objective of this prospective study was to provide an objective quantification of the long-term results of tibial neurotomy. METHODS: This multicenter prospective study was conducted from 1999 to 2003. Fifty-five patients with spastic equinus foot were treated in five neurosurgical centers. Preoperative and postoperative clinical evaluation comprised description of the foot deformity, study of stretch reflexes, evaluation of the repercussions of the deformity, and gait analysis. Selective neurotomy was performed in all patients. RESULTS: No postoperative complications were observed. The mean postoperative follow-up was 10 months. Tibial neurotomy improved the appearance of the foot (equinus and varus deformities, claw toes); the equinus score decreased from 1.54 to 0.273 after the operation. Stretch reflex scores were decreased significantly and for a long term after surgery; the mean triceps surae stretch reflex score decreased from 2.46 to 0.47. The angle of passive dorsiflexion of the ankle increased significantly (from -0.56 degrees to +6.85 degrees). Gait analysis demonstrated a statistically significant increase in the speed of the patient's gait after surgical treatment; the time taken by the patient to walk 10 m at a normal speed in shoes decreased from a mean of 55 seconds to 35.16 seconds. Postoperatively, 92.7% of preoperative objectives had been achieved. CONCLUSION: Tibial neurotomy ensures long-term functional improvement of patients with spastic equinus foot. It provides a lasting response for these patients compared with other, more transient treatments.
Kevin Buffenoir; Thomas Roujeau; Françoise Lapierre; Philippe Menei; Dominique Menegalli-Boggelli; Patrick Mertens; Philippe Decq
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Publication Detail:
Type:  Journal Article; Multicenter Study    
Journal Detail:
Title:  Neurosurgery     Volume:  55     ISSN:  1524-4040     ISO Abbreviation:  Neurosurgery     Publication Date:  2004 Nov 
Date Detail:
Created Date:  2004-10-28     Completed Date:  2005-06-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7802914     Medline TA:  Neurosurgery     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1130-7     Citation Subset:  IM    
Service de Neurochirurgie, Hôpital Henri-Mondor, Assistance Publique-Hôpitaux de Paris, Créteil, France.
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MeSH Terms
Equinus Deformity / rehabilitation,  surgery*
Middle Aged
Muscle Spasticity / rehabilitation,  surgery*
Postoperative Complications
Prospective Studies
Tibial Nerve / physiopathology,  surgery*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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