The split transfer of tibialis anterior tendon to peroneus tertius tendon for equinovarus foot in children with cerebral palsy

Abstract

Relationship between the tilt angle of bipolar radial head prostheses and radiological radiocapitellar instability

The efficacy of split tibial tendon transfers on functional gait outcomes for children and youth with cerebral palsy and spastic equinovarus foot deformities

“…n = 68 patient topography unaccounted for). 7 , 8 , 10 All studies included in the review were aligned with treating foot muscle imbalance in spastic CP muscle tone, however the tone abnormality was not graded in severity prior to surgical intervention.…”

“…Three studies reported use of above-knee casts for at least six weeks with periods of restricted weightbearing, 5 , 12 , 36 with nine reporting the use of below-knee casts and earlier weightbearing. 7 , 8 , 10 , 11 , 14 , 15 , 17 , 29 , 39 Four studies 4 , 5 , 13 , 37 described a combination of above- and below-knee casts. Follow-up times varied widely from one to 16 years, with seven studies 5 , 9 , 10 , 13 , 14 , 29 , 40 reporting outcomes at a mean of five years or more, and six studies over seven years post-surgery.…”

“…All studies reported gait-related outcomes categorized in the ICF body structure and function domain, 30 and three reported measures at the level of activity ( Table III ). 8 , 14 , 40 The most commonly reported gait-related outcome measures included the use of gait analysis, gait observation, ambulation, range of motion (ROM), and clinical grading tools. Table IV outlines the results of overall clinical function at postoperative follow-up.…”

“…The mean ‘success’ rate was 87%, ranging between 75% to 100% (mean follow-up time 6.3 years) of which six studies had a success rate greater than 90% ( Table V ). 4 , 5 , 8 , 13 , 29 , 39 Aleksić et al 15 reported higher rates of surgical success (defined by Kling) in patients with higher levels of gross motor function prior to the surgery: GMFCS I = 100% success, II = 94.8%, III = 69.8%, IV = 9.1%, however the participant numbers in each classification level were not reported. Aleksić et al 15 also reported success rates for patients with hemiplegia (58/65 (89%)), diplegia (29/38 (76%)), and quadriplegia (2/13 (15%)).…”

“…Some studies described gross motor function either by labelling participants as ‘community walkers’, 10 , 11 or by reporting pre-/postoperative GMFCS levels. 8 , 14 Though it should be noted by the reader that the GMFCS is not recommended for use as an outcome measure, both studies reporting on postoperative classifications reported a tendency towards favourable changes in GMFCS levels. While suggestive of improvements in functional mobility, these approaches lack the precision needed to quantify change within the possibly wide range of abilities, and use classification systems in ways for which they were not designed.…”