Correction of planovalgus deformity through rotational reinsertion of the lateral layers of the Achilles tendons in ambulatory children with cerebral palsy

Abstract

Symptomatic planovalgus deformity is a condition commonly seen in patients with cerebral palsy. The authorspropose a new procedure for the management of this deformity through rotational reinsertion of the lateral layersof the Achilles tendon, and then they assess its benefit by comparing plantar pressure distribution patterns in chil-dren preoperatively and at 6- and 12-month intervals postoperatively. Pedobarographic measurements, range ofmotion of the ankle, and radiographic indexes were used to assess the outcome of the surgery. The functional abil-ities of the patients were assessed based on the Gross Motor Function Classification System. A total of 37 feet (22patients) were included, with a mean§standard deviation age at surgery of 11.8§2.7 (range 9.1 to 14.5) years.All feet were managed through rotational reinsertion of the lateral layers of the Achilles tendon. Surgical correc-tion of planovalgus has good outcomes. Significant changes were observed with statistical significance at the 5%(p≤.05) level in plantar pressure distribution in children preoperatively and at 6- and 12-month intervals postop-eratively. The results show that the proposed method of surgery is effective in the correction of planovalgus inambulatory children with cerebral palsy.