Hallux valgus in cerebral palsy

NewsBot · Feb 28, 2018

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Surgical correction of hallux valgus deformity in children with cerebral palsy
Ilker AbdullahSarikayaaAliSekerbOzan AliErdalaMehmet AliTalmaccMuharremInana
Acta Orthopaedica et Traumatologica Turcica 22 February 2018

Objective
This study aimed to present a treatment algorithm for the correction of the hallux valgus deformity in Cerebral Palsy (CP) patients and to discuss the outcomes based on our clinical and radiological results.

Methods
29 patients (45 feet) were included in the study. The mean age of the patients at the time of the surgery was 14 (range 6–22) years. The mean follow-up was 33 (range 22–59) months. A reconstructive procedure was performed on 19 patients (27 feet); a soft tissue surgery and exostectomy of the bunion in six patients (11 feet); and MTP joint arthrodesis in four patients (7 feet). The hallux valgus angle (HVA) and the anteroposterior intermetatarsal angle (IMA) were used for radiologic evaluation and the DuPont Bunion Rating Score was used for clinical evaluation.

Results
The follow-up period was 36 (range 22–59) months in reconstructive group, 27 (range 24–29) months in soft tissue group, and 29 (range 23–41) months in MTP arthrodesis group. Significant improvements were detected in hallux valgus angle in three groups postoperatively but in soft tissue group correction loss was observed during follow up. Best results were achieved in arthrodesis group and worse in soft tissue group in terms of clinical evaluation.

Conclusion
According to our results isolated soft tissue procedures are ineffective in CP patients. Soft tissue procedure combined with metatarsal osteotomy has satisfactory results. Level of evidence
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Admin2 · Feb 28, 2018

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NewsBot · Jan 17, 2022

Hallux valgus surgery in children with cerebral palsy: A systematic review
T L Lewis et al
Foot Ankle Surg. 2021 Dec 24

Background: Children with cerebral palsy are highly likely to develop foot deformities, some of which may require surgical intervention. Hallux valgus is a common forefoot deformity which can cause issues with pain, footwear, orthotic splints and soft tissues. It remains unclear what the optimal surgical treatment is for children with cerebral palsy and hallux valgus deformity.

Objective: To systematically review studies reporting the clinical and radiological outcomes of surgical correction of hallux valgus deformity in children with cerebral palsy.

Methods: A systematic review of studies published in electronic databases (Medline, Embase, Pubmed and Cochrane library) from inception until January 2021. Keywords related to hallux valgus and cerebral palsy were included.

Results: 58 studies were identified of which 7 met the criteria for inclusion. 200 feet in 134 patients with a mean age of 13.5 years were included, with a mean follow up period of 43 months. A range of clinical and radiographic outcomes were assessed. A treatment framework for the assessment and management of hallux valgus in children with cerebral palsy based on the published evidence is presented.

Conclusion: Non-ambulant children with cerebral palsy with symptomatic hallux valgus should primarily undergo first MTPJ arthrodesis whilst those who are ambulant should undergo first metatarsal osteotomy± soft tissue correction.
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NewsBot · Oct 10, 2023

Arthrodesis of the first metatarsophalangeal
joint for severe hallux valgus in adolescents
with cerebral palsy: A retrospective
comparison study of three
surgical techniques
Ken Ye et al
Journal of Children’s Orthopaedics 00(0)

Purpose: We compared the outcomes of arthrodesis of the first metatarsophalangeal joint for severe hallux valgus in 31
adolescents with cerebral palsy, using three different methods of fixation: K-wires, non-locking plates, and locking plates.
Methods: Clinical outcomes included time to weight-bearing, fusion rates and surgical complications. Radiographic
assessment included comparing pre- and post-operative hallux valgus angles, intermetatarsal angles, interphalangeal angles,
and lateral metatarsophalangeal angles. Patient-reported outcomes included pre- and post-operative visual analogue scales
addressing bunion pain and concerns, difficulties with wearing shoes and braces, and difficulties with foot hygiene.
Results: Of the 31 adolescents (16 male), 10 patients had K-wire fixation, 11 had a non-locking dorsal plate, and 10
had fixation with a dorsal locking plate. Mean age at surgery was 16years (12–18 years) and mean follow-up was 4 years
(2.7–6.5years). Patients with K-wire fixation had delayed weight-bearing and had more complications than those managed
by dorsal plating. There were significant improvements in radiographic parameters (except interphalangeal angle) and in
patient-reported outcomes, in all groups (p<0.001). However, radiographic and clinical outcomes were better in the
dorsal plating groups compared to the K-wire group.
Conclusion: Arthrodesis of the first metatarsophalangeal joint gave good correction of deformity with improvements
in symptoms and radiographic parameters in adolescents with cerebral palsy. We recommend dorsal plating that allowed
early weight-bearing and had fewer complications with better clinical and radiographic outcomes, than K-wire fixation
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NewsBot · Oct 12, 2023

This clinical trial was just registered:
Hallux Valgus Treatment Developed for Children With Cerebral Palsy

This study is a clinical trial.Hallux valgus, one of the common deformities in the foot in children with diplegic Cerebral Palsy, has caused serious problems in daily life activities in children and has usually resulted in surgical operation. Due to the lack of sufficient studies on this topic, our aim in our study is to show the importance of exercise and mobilization applied by physiotherapists in the early stages of hallux valgus deformity, which is common in children with Cerebral palsy, in correcting the deformity, and an example exercise program for physiotherapists.

The study will include 15 individuals with cerebral palsy diagnosed with hallux valgus by a physician at the Physiotherapy and Rehabilitation clinic at Istanbul FSM Madenler Medical Center according to the following criteria. Children diagnosed with diplegic SP, aged 9-16, with Communication Function Classification System Levels 1 and 2, ambulation level GMFCS 1-2, using AF Dec and GRAPHO and without any auxiliary device use, Manchester scale stages 1 and 2 will be included. Those who cannot walk independently, GMSCS 3 and above, children using assistive devices, Communication Function Classification System Level 3 and above, children with Manchester scale Stage 3 hallux valgus will be excluded from the study.Manchester November Scale for Hallux valgus classification, Hallux valgus angle and Foot and Ankle joint range of motion goniometer, Spasticity Modified Ashworth Scale (MAS), Foot and Ankle muscle strength Kendall Manual Muscle Strength Assessment, Pain Visual Analogue Scale (VAS), Communication skill Communication Function Classification System with Gross Motor Function Classification System GMFCS level, American orthopedic foot-ankle association-hallux MTF-IF scale evaluation is planned.
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NewsBot · Jan 6, 2024

Arthrodesis of the first metatarsophalangeal joint for severe hallux valgus in adolescents with cerebral palsy: A retrospective comparison study of three surgical techniques
Ken Ye et al
J Child Orthop. 2023 Oct 5;17(6):607-617.

Purpose: We compared the outcomes of arthrodesis of the first metatarsophalangeal joint for severe hallux valgus in 31 adolescents with cerebral palsy, using three different methods of fixation: K-wires, non-locking plates, and locking plates.

Methods: Clinical outcomes included time to weight-bearing, fusion rates and surgical complications. Radiographic assessment included comparing pre- and post-operative hallux valgus angles, intermetatarsal angles, interphalangeal angles, and lateral metatarsophalangeal angles. Patient-reported outcomes included pre- and post-operative visual analogue scales addressing bunion pain and concerns, difficulties with wearing shoes and braces, and difficulties with foot hygiene.

Results: Of the 31 adolescents (16 male), 10 patients had K-wire fixation, 11 had a non-locking dorsal plate, and 10 had fixation with a dorsal locking plate. Mean age at surgery was 16 years (12-18 years) and mean follow-up was 4 years (2.7-6.5 years). Patients with K-wire fixation had delayed weight-bearing and had more complications than those managed by dorsal plating. There were significant improvements in radiographic parameters (except interphalangeal angle) and in patient-reported outcomes, in all groups (p < 0.001). However, radiographic and clinical outcomes were better in the dorsal plating groups compared to the K-wire group.

Conclusion: Arthrodesis of the first metatarsophalangeal joint gave good correction of deformity with improvements in symptoms and radiographic parameters in adolescents with cerebral palsy. We recommend dorsal plating that allowed early weight-bearing and had fewer complications with better clinical and radiographic outcomes, than K-wire fixation.
Click to expand...

Hallux valgus in cerebral palsy

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Hallux valgus in cerebral palsy

NewsBot The Admin that posts the news.

Admin2 Administrator Staff Member

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

Morphology and deformity of the distal phalanx in hallux valgus

Peroneus longus contraction and hallux valgus

Nerves around hallux valgus

Clinical guidelines for hallux valgus

Hallux valgus in those with diabetes

Epidemiology of hallux valgus surgery

Who does research on hallux valgus?

Share This Page

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