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A Review of Decision Making in Foot Problems in Cerebral Palsy

Volume 8 | Issue 3 | September-December 2022 | Page: 02-05| Rohan Parwani DOI- https://doi.org/10.13107/ijpo.2022.v08i03.142 Authors: Rohan Parwani [1] [1] Department of Orthopaedics, Shri M P Shah Medical College, Jamnagar, Gujarat, India. Address of Correspondence Dr. Rohan Parwani Assistant Professor, Department of Orthopaedics, Shri M. P Shah Medical College, Jamnagar, Gujarat, India. E-mail: arthorohan@gmail.com Abstract […]

Combined Hemiepiphysiodesis Using Tension Band Plate and Osteotomy for Severe Coronal Plane Deformities Around Knee Joint in Children with Skeletal Dysplasia – An Innovative Technique

Volume 8 | Issue 2 | May-August 2022 | Page: 20-23 | Anil Agarwal, Ankit Jain, Ravi Jethwa, Jatin Raj Sareen DOI- https://doi.org/10.13107/ijpo.2022.v08i02.139 Authors: Anil Agarwal MS Ortho [1], Ankit Jain D Ortho [1], Ravi Jethwa MS Ortho [1], Jatin Raj Sareen MS Ortho [1] [1] Department of Paediatric Orthopaedics, Chacha Nehru Bal Chikitsalaya, Delhi, India. […]

A Review of Decision Making in Foot Problems in Cerebral Palsy

Combined Hemiepiphysiodesis Using Tension Band Plate and Osteotomy for Severe Coronal Plane Deformities Around Knee Joint in Children with Skeletal Dysplasia – An Innovative Technique

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A Review of Decision Making in Foot Problems in Cerebral Palsy

Volume 8 | Issue 3 | September-December 2022 | Page: 02-05| Rohan Parwani

DOI- https://doi.org/10.13107/ijpo.2022.v08i03.142

Authors: Rohan Parwani [1]

[1] Department of Orthopaedics, Shri M P Shah Medical College, Jamnagar, Gujarat, India.

Address of Correspondence

Dr. Rohan Parwani
Assistant Professor, Department of Orthopaedics, Shri M. P Shah Medical College, Jamnagar, Gujarat, India.
E-mail: arthorohan@gmail.com

Abstract

Ambulatory children with cerebral palsy suffer from a range of problems. There are issues with stance, stability, posture, and endurance. The foot plays a significant role in the pathogenesis and treatment of these problems, especially in the lower limb. Our review article tries to highlight the foot problems and their solutions. The most common deformity in a child with cerebral palsy is the hindfoot equinus. This fixed deformity leads to poor balance in stance and reduced power generated during the push-off phase. Proper identification of the gait pattern and the role of the foot in deranging the gait can help decide ways to enhance the walk of a cerebral palsy child. Physiotherapy and stretching are vital to improving muscle physiology and growth. The weak muscles need to be supplemented with splints. There is also a significant role in the judicious use of surgery in cerebral palsy. Deciding which surgery to employ is critical and often contributes to the success or a disastrous failure. Our article highlights various facets of decision-making and ways to arrive at a proper decision.
Keywords- Cerebral palsy, Foot, Equinus, Gait

References

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How to Cite this Article: Parwani R | A Review of Decision Making in Foot Problems in Cerebral Palsy | International Journal of Paediatric Orthopaedics | May-August 2022; 8(2): 02-05.
https://doi.org/10.13107/ijpo.2022.v08.i03.142

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Combined Hemiepiphysiodesis Using Tension Band Plate and Osteotomy for Severe Coronal Plane Deformities Around Knee Joint in Children with Skeletal Dysplasia – An Innovative Technique

Volume 8 | Issue 2 | May-August 2022 | Page: 20-23 | Anil Agarwal, Ankit Jain, Ravi Jethwa, Jatin Raj Sareen

DOI- https://doi.org/10.13107/ijpo.2022.v08i02.139

Authors: Anil Agarwal MS Ortho [1], Ankit Jain D Ortho [1], Ravi Jethwa MS Ortho [1], Jatin Raj Sareen MS Ortho [1]

[1] Department of Paediatric Orthopaedics, Chacha Nehru Bal Chikitsalaya, Delhi, India.

Address of Correspondence

Dr. Anil Agarwal
Department of Paediatric Orthopaedics, Chacha Nehru Bal Chikitsalaya, Delhi, India.
E-mail: rachna_anila@yahoo.co.in

Abstract

Skeletal dysplasia in children is sometimes associated with severe coronal plane angulations around the knee. The associated ligament laxity adds to the complexity of surgical correction. Osteotomies require precise surgical planning and execution. Hemiepiphyseodesis is usually employed only in mild and moderate deformity. Distraction osteogenesis method is labour intensive, costly and requires a prolonged treatment course. We describe an innovative surgical technique which combines hemiepiphysiodesis using tension-band plates and a metaphyseal osteotomy. The technique utilises acute bony correction by osteotomy followed by residual correction, if any and soft tissue fine tuning through growth modulation. Growth modulation also addresses recurrence to some extent. The surgical technique is described along with illustrative case examples.
Keywords: Skeletal dysplasia, Osteotomy, Hemiepiphyseodesis

References

1. Bassett GS. Orthopaedic aspects of skeletal dysplasias. Instr Course Lect. 1990;39:381-387.
2. Rosskopf AB, Buck FM, Pfirrmann CW, Ramseier LE. Femoral and tibial torsion measurements in children and adolescents: comparison of MRI and 3D models based on low-dose biplanar radiographs. Skeletal Radiol. 2017;46:469-476.
3. Thacker MM, Davis ED, Ditro CP, Mackenzie W. Limb lengthening and deformity correction in patients with skeletal dysplasias. In: Sabharwal S (eds.). Pediatric Lower Limb Deformities. Springer, Cham; 2016. doi: 10.1007/978-3-319-17097-8_19
4. Bell DF, Boyer MI, Armstrong PF. The use of the Ilizarov technique in the correction of limb deformities associated with skeletal dysplasia. J Pediatr Orthop. 1992;12:283-290. doi: 10.1097/01241398-199205000-00003
5. Pinkowski JL, Weiner DS. Complications in proximal tibial osteotomies in children with presentation of technique. J Pediatr Orthop. 1995;15:307-312.
6. Yilmaz G, Oto M, Thabet AM, Rogers KJ, Anticevic D, Thacker MM, Mackenzie WG. Correction of lower extremity angular deformities in skeletal dysplasia with hemiepiphysiodesis: a preliminary report. J Pediatr Orthop. 2014;34:336-345. doi: 10.1097/BPO.0000000000000089
7. Cho TJ, Choi IH, Chung CY, Yoo WJ, Park MS, Lee DY. Hemiepiphyseal stapling for angular deformity correction around the knee joint in children with multiple epiphyseal dysplasia. J Pediatr Orthop. 2009;29:52-56.
8. Shabtai L, Herzenberg JE. Limits of growth modulation using tension band plates in the lower extremities. J Am Acad Orthop Surg. 2016;24):691-701. doi: 10.5435/JAAOS-D-14-00234
9. Masquijo JJ, Artigas C, de Pablos J. Growth modulation with tension-band plates for the correction of paediatric lower limb angular deformity: current concepts and indications for a rational use. EFORT Open Rev. 2021;6:658-668. doi: 10.1302/2058-5241.6.200098
10. Bell DF, Boyer MI, Armstrong PF. The use of the Ilizarov technique in the correction of limb deformities associated with skeletal dysplasia. J Pediatr Orthop. 1992;12:283-290.
11. Myers GJ, Bache CE, Bradish CF. Use of distraction osteogenesis techniques in skeletal dysplasias. J Pediatr Orthop. 2003;23:41-45.

How to Cite this Article: K Agarwal A, Jain A, Jethwa R, Sareen JR | Combined Hemiepiphysiodesis Using Tension Band Plate and Osteotomy for Severe Coronal Plane Deformities Around Knee Joint in Children with Skeletal Dysplasia – An Innovative Technique | International Journal of Paediatric Orthopaedics | May- August 2022; 8(2): 20-23.
https://doi.org/10.13107/ijpo.2022.v08i02.139

Half Sized Blog Element (Single Author Style)

Half Sized Blog Element (Multi Author Style)

A Review of Decision Making in Foot Problems in Cerebral Palsy

Combined Hemiepiphysiodesis Using Tension Band Plate and Osteotomy for Severe Coronal Plane Deformities Around Knee Joint in Children with Skeletal Dysplasia – An Innovative Technique

A Review of Decision Making in Foot Problems in Cerebral Palsy

Combined Hemiepiphysiodesis Using Tension Band Plate and Osteotomy for Severe Coronal Plane Deformities Around Knee Joint in Children with Skeletal Dysplasia – An Innovative Technique

Full Sized Blog Element (Big Preview Pic)

A Review of Decision Making in Foot Problems in Cerebral Palsy

Authors: Rohan Parwani [1]

Abstract

(Article Text HTML) (Full Text PDF)

Combined Hemiepiphysiodesis Using Tension Band Plate and Osteotomy for Severe Coronal Plane Deformities Around Knee Joint in Children with Skeletal Dysplasia – An Innovative Technique

Authors: Anil Agarwal MS Ortho [1], Ankit Jain D Ortho [1], Ravi Jethwa MS Ortho [1], Jatin Raj Sareen MS Ortho [1]

Abstract

(Article Text HTML) (Full Text PDF)

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