Surgical management of hallux valgus deformity in children with cerebral palsy.

Abstract

Twenty-six cases of hallux valgus deformity, in 16 children with cerebral palsy, were managed with great toe metatarsophalangeal (MTP) arthrodesis. Mean age at the time of surgery was 16 years (range, 10 years and 11 months to 21 years and 11 months), and mean follow-up was 4 years and 11 months (range, 2 years and 1 month to 10 years). Significant improvement in the hallux valgus angle (preoperative, 36.3 degrees; follow-up, 9.6 degrees; p < 0.05), the intermetatarsal angle (preoperative, 12.3 degrees; follow-up, 8.4 degrees; p < 0.05), and lateral metatarsophalangeal angle (preoperative, 4.8 degrees; follow-up, 25.8 degrees; p < 0.05), were achieved and maintained after MTP arthrodesis. Functional outcome was documented by significant improvement in the modified American Orthopaedic Foot and Ankle Society Hallux Metatarsophalangeal-Interphalangeal Scale (preoperative mean score, 46.2; follow-up mean score, 90.9; p < 0.05). Patient/ parent/caregiver satisfaction (as determined by a questionnaire), with improvements in cosmesis, footwear, hygiene, activity, and pain were high, ranging from 81% to 100%. Hallux valgus deformity in children with cerebral palsy is best managed by MTP arthrodesis, in conjunction with other surgical procedures that address segmental foot malalignment and dynamic gait deviations.

• Authors: J R Davids, T A Mason, A Danko, D Banks, D Blackhurst
• Journal: Journal of pediatric orthopedics (J Pediatr Orthop) 2001 Jan-Feb Vol. 21 Issue 1 Pg. 89-94 ISSN: 0271-6798 [Print] United States
• PMID: 11176360 (Publication Type: Journal Article)

Topics

• Adolescent
• Adult
• Arthrodesis (methods)
• Cerebral Palsy (complications, physiopathology)
• Child
• Female
• Hallux Valgus (etiology, physiopathology, surgery)
• Humans
• Male
• Patient Satisfaction
• Retrospective Studies
• Surveys and Questionnaires
• Treatment Outcome