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Equinus + pediatric

Barbara Kelly, Marilyn MacKay-Lyons, Susan Berryman, Joe Hyndman, Ellen Wood
AIM: To study the effects of single versus serial casting post-Botulinum toxin A (BoNT-A) injections on hypoextensibility of triceps surae in children, 2-7 years old, with cerebral palsy and equinus gait. METHODS: A randomized, stratified, parallel, two-group trial was conducted at a pediatric health center with assessments at baseline, precast, postcast and, 1-, 2-, and 6-month follow-ups. One week following BoNT-A injections into triceps surae muscle, a single below-knee cast (n = 10) or 3 serial casts (n = 10) were applied for 3 weeks...
May 17, 2018: Physical & Occupational Therapy in Pediatrics
Mael Lintanf, Jean-Sébastien Bourseul, Laetitia Houx, Mathieu Lempereur, Sylvain Brochard, Christelle Pons
OBJECTIVE: To determine the effects of ankle-foot orthoses (AFOs) on gait, balance, gross motor function and activities of daily living in children with cerebral palsy. DATA SOURCES: Five databases were searched (Pubmed, Psycinfo, Web of Science, Academic Search Premier and Cochrane Library) before January 2018. REVIEW METHODS: Studies of the effect of AFOs on gait, balance, gross motor function and activities of daily living in children with cerebral palsy were included...
April 1, 2018: Clinical Rehabilitation
Michael Seungcheol Kang, Il-Yeong Hwang, Soo-Sung Park
BACKGROUND: Selective soft tissue release (SSTR), which includes a combination of abductor hallucis, tibialis posterior, and Achilles lengthening, has been used in patients with recurrent clubfoot deformity after Ponseti treatment. The aim of this study was to investigate the prognostic factors for recurrence of clubfoot deformity after SSTR. METHODS: Consecutive patients with idiopathic clubfoot and residual or recurrent deformity after Ponseti treatment underwent SSTR between 2005 and 2013...
February 1, 2018: Foot & Ankle International
Masayoshi Oguri, Yoshiaki Saito, Tetsuya Okazaki, Wataru Matsumura, Koyo Ohno, Masami Togawa, Chisako Fukuda, Yuko Saito, Ichizo Nishino, Yoshihiro Maegaki
A 12-year-old girl presented with talipes equinus of both legs, attenuation of upper and lower limb tendon reflexes, thermal hyperalgesia, and reduction of vibratory sensation. On clinical examination, muscle twitches of fingers of both hands, as well as the abductor halluces and the dorsal interossei muscles of the right foot were observed. Nerve conduction velocity was significantly declined in the upper and lower extremities. Needle electromyography (EMG) was not performed; however, ultrasonography revealed repetitive, semi-regular muscle twitches lasting 0...
August 2017: Brain & Development
Ann Tilton, Barry Russman, Resa Aydin, Umit Dincer, Raul G Escobar, Sehim Kutlay, Zbigniew Lipczyk, Juan Carlos Velez, Anne-Sophie Grandoulier, Anissa Tse, Philippe Picaut, Mauricio R Delgado
This secondary analysis of a large (n = 241), randomized, double-blind study evaluated the efficacy of 2 doses of abobotulinumtoxinA + standard of care (SOC) versus placebo + SOC in enabling children with dynamic equinus due to cerebral palsy to achieve their functional goals using Goal Attainment Scaling. Most parents/caregivers selected goals targeting aspects of gait improvement as most relevant. Mean (95% confidence interval) Goal Attainment Scaling T scores at week 4 were higher for both abobotulinumtoxinA groups versus placebo (treatment difference vs placebo: 10 U/kg/leg: 5...
April 2017: Journal of Child Neurology
Marion Prigent, Sylvain Brochard, Mathias Thepaut, Christian Lefèvre, Dominique Le Nen, Thierry Cornic, Marie-Thérèse Cariou, Catherine Le Rouzic, Phlippe Le Moine, Christelle Pons, Laetitia Houx
OBJECTIVE: Traumatic lower limb amputation is rare in pediatric population, and surgeons always try limb salvage. But rarely, later amputation occurred when the traumatic limb is painful. It is a difficult and irreversible decision needed a multidisciplinary approach. We report how we managed a programmed trans-tibial amputation on 13-years-old boy, 20 months after a foot trauma. OBSERVATIONS: Our patient is an adolescent victim of a left foot crash. The first checkup showed a degloving injury, dislocation of the interphalangeal joints and of all toes...
September 2016: Annals of Physical and Rehabilitation Medicine
Kai Rong, Wen-tao Ge, Xing-chen Li, Xiang-yang Xu
BACKGROUND: Intramuscular lengthening of the gastrocnemius and/or soleus (Baumann procedure) is widely used in patients who have cerebral palsy, with several advantages over other lengthening techniques. Tightness of the gastrocnemius or gastrocnemius-soleus complex has been confirmed to be related to flatfoot deformity. The purpose of this study was to evaluate the mid-term results of the Baumann procedure as a part of the treatment of flatfoot with equinus deformity. METHODS: We reviewed 35 pediatric and adult patients (43 feet) with flatfoot who underwent the Baumann procedure for the concomitant equinus deformity...
October 2015: Foot & Ankle International
Alper I Dai, Sefika N Aksoy, Abdullah T Demiryürek
This retrospective study aimed to compare the therapeutic response, including side effects, for oral baclofen versus oral tizanidine therapy with adjuvant botulinum toxin type A in a group of 64 pediatric patients diagnosed with static encephalopathy and spastic equinus foot deformity. Following botulinum toxin A treatment, clinical improvement led to the gradual reduction of baclofen or tizanidine dosing to one-third of the former dose. Gross Motor Functional Measure and Caregiver Health Questionnaire scores were markedly elevated post-botulinum toxin A treatment, with scores for the tizanidine (Gross Motor Functional Measure: 74...
February 2016: Journal of Child Neurology
Chris C Cychosz, Phinit Phisitkul, Daniel A Belatti, Mark A Glazebrook, Christopher W DiGiovanni
BACKGROUND: Gastrocnemius recession is a surgical technique commonly performed on individuals who suffer from symptoms related to the restricted ankle dorsiflexion that results when tight superficial posterior compartment musculature causes an equinus contracture. Numerous variations for muscle-tendon unit release along the length of the calf have been described for this procedure over the past century, although all techniques share at least partial or complete release of the gastrocnemius muscle given its role as the primary plantarflexor of the ankle...
June 2015: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
I Housni Alaoui, O Hocar, N Akhdari, S Amal, M Hakkou, G Hokoumi, G Draiss, M Bouskraoui
INTRODUCTION: Idiopathic palmoplantar hidradenitis is an uncommon neutrophilic dermatosis, occurring in children and young adults. Its pathogenesis is incompletely understood. It is characterized by spontaneous resolution, but it can relapse in 50% of cases. We describe a case of a child with atypical idiopathic hidradenitis remarkable for its impact on his motor development. OBSERVATION: A 3-year-old boy was admitted to the pediatric unit for etiological assessment of delayed walking...
March 2015: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
Harpreet Chhina, Alyssa Howren, Andrea Simmonds, Christine M Alvarez
BACKGROUND: Pediatric indications for Onabotulinumtoxin A extend beyond treatment of skeletal muscle conditions. Each of the indications for Onabotulinumtoxin A use have adverse events reported in the past. The aim of this study was to review dverse events in children less than 2 years of age who were treated with Onabotulinumtoxin A injections as part of equinus foot deformity, in the setting of clubfoot at British Columbia's Children Hospital. METHODS: A retrospective review of all clubfoot patients at British Columbia's Children Hospital, less than 2 years of age, who received a Onabotulinumtoxin A injection for equinus correction, between September 2000 and December 2012 was conducted...
March 2014: European Journal of Paediatric Neurology: EJPN
Chris Church, Julie A Coplan, Dijana Poljak, Ahmed M Thabet, Durga Kowtharapu, Nancy Lennon, Stephanie Marchesi, John Henley, Roland Starr, Dan Mason, Mohan V Belthur, John E Herzenberg, Freeman Miller
PURPOSE: Isolated congenital clubfoot can be treated either operatively (posteromedial release) or conservatively (Ponseti method). This study retrospectively compared mid-term outcomes after surgical and Ponseti treatments to a normal sample and used multiple evaluation techniques, such as detailed gait analysis and foot kinematics. METHODS: Twenty-six children with clubfoot treated surgically and 22 children with clubfoot treated with the Ponseti technique were evaluated retrospectively and compared to 34 children with normal feet...
March 2012: Journal of Children's Orthopaedics
Richard M Jay, Nadia Din
BACKGROUND: Flatfoot deformities are common in children and are treated using many conservative and surgical approaches. Subtalar extra-articular arthroereisis, in particular, limits talar motion, spares the subtalar joint, and prevents excessive subtalar joint pronation. Addressing the underlying equinus deformity with gastrocnemius recession is an important factor in optimizing outcomes in patients with flatfoot deformity. METHODS: This study included 20 children, 4 to 17 years old...
April 2013: Foot & Ankle Specialist
F Schiedel, B Vogt, S Wacker, J Pöpping, K Bosch, R Rödl, D Rosenbaum
Wearing an external fixator for several months can be expected to profoundly affect the ability to walk, but, in principle, full weight-bearing is possible during corrective procedures with the Taylor Spatial Frame (TSF). The present prospective cohort study was conducted to assess whether patients are able to walk with or without crutches during treatment with a TSF on the lower leg. Twenty-four patients (10 girls, 14 boys; average age 11 years, range 6-17) scheduled for fixator surgery with osteotomies in the lower leg and foot mounting were included...
July 2012: Gait & Posture
Vladan B Stevanović, Zoran S Vukasinović, Zoran Lj Bascarević, Galina B Stevanović, Dusko V Spasovski
Clubfoot, or talipes equinovarus, is a deformity consisting of equinus, varus, and adductus foot deformity. The true etiology of congenital clubfoot is unknown; several theories have been proposed. The pathology of the individual bones contributes to the clubfoot deformity and soft tissue contractures around the ankle and talocalcaneonavicular joint maintains the deformity and involve muscles, tendons, tendon sheaths, ligaments and joint capsules. Various treatment regimens have been proposed, including the use of corrective splinting, taping, and casting...
2011: Acta Chirurgica Iugoslavica
Samir Shaheen, Hiba Jaiballa, Shafique Pirani
The Ponseti method, now regarded as the standard of care for congenital clubfoot, is equally effective whether provided by orthopaedic surgeons or orthopaedic paramedics. Therefore, it is particularly suitable for under-resourced nations with lack of surgeons and physicians. At the Sudan Clubfoot Clinic, physiotherapy assistants (3-year diploma nurses with additional physiotherapy experience) are part of the Ponseti clubfoot treatment team, with the role of assessing the degree of deformity by the Pirani score to assist the team in providing treatment...
July 2012: Journal of Pediatric Orthopedics. Part B
Birol Balaban, Fatih Tok, A Kenan Tan, Dennis J Matthews
OBJECTIVE: This study aimed to evaluate the effects of botulinum toxin A (BTX-A) treatment on energy expenditure and ambulation in children with cerebral palsy (CP) and to determine if energy expenditure measurement could be considered a useful tool for evaluating the effectiveness of BTX-A treatment for CP. DESIGN: The study included 16 pediatric CP patients with equinus deformity who were capable of walking without assistance (group with CP). The children with CP were administered BTX-A injections into the gastrocnemius muscle...
January 2012: American Journal of Physical Medicine & Rehabilitation
Alice Chu, Amy S Labar, Debra A Sala, Harold J P van Bosse, Wallace B Lehman
BACKGROUND: Many different clubfoot classification systems have been proposed, but no single one is universally accepted. Two frequently cited systems, developed by Dimeglio/Bensahel and Catterall/Pirani, are often used for evaluation purposes in the treatment of idiopathic clubfoot. Our hypothesis was that the initial scores would be positively correlated with the number of casts required for clubfoot correction, indicating to us that the more severe score would require more casts, and therefore truly show the accuracy and usefulness of the scoring system...
October 2010: Journal of Pediatric Orthopedics
Andrea D Cass, Craig A Camasta
Pediatric pes planovalgus deformity may be classified as flexible or rigid. The rigid pes planovalgus is often a result of a tarsal coalition, which is typically characterized as a painful unilateral or bilateral deformity, frequently associated with peroneal spasm. However, many tarsal coalitions are asymptomatic and demonstrate no peroneal spasm or pes planovalgus deformity. Likewise, the severe pes planovalgus foot type can demonstrate some of the same clinical and radiographic features of a tarsal coalition, especially in the obese adolescent patient...
May 2010: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Robert M Greenhagen, Adam R Johnson, Matthew C Peterson, Lee C Rogers, Nicholas J Bevilacqua
The gastrocnemius recession is a popular surgical procedure for the treatment of equinus contracture. Lengthening the gastrocnemius tendon has been show to be an effective means of reducing pressure to the plantar forefoot by weakening the triceps surae complex. The more traditional method of weakening the triceps surae is a modification of Hoke's triple hemisection through the tendoAchillis. This technique unfortunately carries a serious risk of the development of a calcaneal gait. The purpose of this case report is to demonstrate that the gastrocnemius recession is an effective and safe alternative to the traditional tendoAchillis lengthening...
March 2010: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
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