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Split Transfer of Tibialis Posterior for Dynamic Equinovarus Deformity in Children with Cerebral Palsy

Volume 9 | Issue 2 | May-August 2023 | Page: 06-09 | Ravi Chandra Vattipalli, Manoranjan Bandela DOI- https://doi.org/10.13107/ijpo.2023.v09.i02.164 Submitted: 14/12/2022; Reviewed: 12/02/2023; Accepted: 15/05/2023; Published: 10/08/2023 Authors: Ravi Chandra Vattipalli DNB Ortho, Manoranjan Bandela MS Ortho [1] Department of Orthopaedics, Apollo Hospitals, Visakhapatnam, Andhra Pradesh, India. Address of Correspondence Dr. Ravichandra Vattipalli, Consultant Orthopaedic […]

Functional Outcome after Revision Surgery for Developmental Dysplasia of the Hip (DDH)

Volume 9 | Issue 2 | May-August 2023 | Page: 21-26 | Atul Bhaskar DOI- https://doi.org/10.13107/ijpo.2023.v09.i02.167 Submitted: 24/02/2023; Reviewed: 18/03/2023; Accepted: 25/05/2023; Published: 10/08/2023 Authors: Atul Bhaskar MS Ortho, FRCS Ortho [1] [1] Department of Orthopaedics, Bombay Hospital Institute of Medical Sciences, Mumbai, Maharashtra, India. Address of Correspondence Dr. Atul Bhaskar, Paediatric Orthopaedic Surgeon, Department of […]

Split Transfer of Tibialis Posterior for Dynamic Equinovarus Deformity in Children with Cerebral Palsy

Functional Outcome after Revision Surgery for Developmental Dysplasia of the Hip (DDH)

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Split Transfer of Tibialis Posterior for Dynamic Equinovarus Deformity in Children with Cerebral Palsy

Volume 9 | Issue 2 | May-August 2023 | Page: 06-09 | Ravi Chandra Vattipalli, Manoranjan Bandela

DOI- https://doi.org/10.13107/ijpo.2023.v09.i02.164

Submitted: 14/12/2022; Reviewed: 12/02/2023; Accepted: 15/05/2023; Published: 10/08/2023

Authors: Ravi Chandra Vattipalli DNB Ortho, Manoranjan Bandela MS Ortho

[1] Department of Orthopaedics, Apollo Hospitals, Visakhapatnam, Andhra Pradesh, India.

Address of Correspondence

Dr. Ravichandra Vattipalli,
Consultant Orthopaedic Surgeon, Apollo Hospitals, Visakhapatnam, Andhra Pradesh, India.
E-mail: vatravi@hotmail.com

Abstract

Children with cerebral palsy often have foot deformities, equinovarus being one of the most common deformities. Several procedures have been advocated, centered around rerouting the tibialis posterior tendon. Whole transfer of the tendon is associated with poor results. The current study aims to establish the efficacy of split tendon transfer of the posterior tibial tendon rerouted through the interosseous membrane and anchored to the lateral cuneiform. Surgical results were analyzed using an indigenously developed score, considering the cultural need for bare foot walking.
Keywords- Split tendon transfer of tibialis posterior, Equinovarus deformity, Cerebral palsy

References

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How to Cite this Article: Vattipalli R, Bandela M | Split Transfer of Tibialis Posterior for Dynamic Equinovarus Deformity in Children with Cerebral Palsy | International Journal of Paediatric Orthopaedics | May-August 2023; 9(2): 06-09 | https://doi.org/10.13107/ijpo.2023.v09.i02.164

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Functional Outcome after Revision Surgery for Developmental Dysplasia of the Hip (DDH)

Volume 9 | Issue 2 | May-August 2023 | Page: 21-26 | Atul Bhaskar

DOI- https://doi.org/10.13107/ijpo.2023.v09.i02.167

Submitted: 24/02/2023; Reviewed: 18/03/2023; Accepted: 25/05/2023; Published: 10/08/2023

Authors: Atul Bhaskar MS Ortho, FRCS Ortho [1]

[1] Department of Orthopaedics, Bombay Hospital Institute of Medical Sciences, Mumbai, Maharashtra, India.

Address of Correspondence

Dr. Atul Bhaskar,
Paediatric Orthopaedic Surgeon, Department of Orthopaedics, Bombay Hospital Institute of Medical Sciences, Mumbai, Maharashtra, India.
E-mail: arb_25@yahoo.com

Abstract

Background: Failure after primary DDH surgery can occur early or immediate, delayed (within six months) and late due to poor remodelling. We report the short-term results after revision surgery in eighteen children including four early and 14 delayed failures.
Patient and Methods: Between 2002 and 2017, eighteen children (19 hips) underwent primary surgery at a mean age of 19 months (range: 9 months – 24 months). There were 12 girls and 6 boys in the study, with nine left and eight right sided dislocations. One child had bilateral dislocation. The mean age at revision surgery was 30 months (range: 22 months – 48 months).
Results: All cases were assessed with the modified Ponseti score to include squatting and cross-leg sitting. Eleven children (61%) were completely pain free, able to squat (Modified Ponseti score 1 and 2), three (17%) had mild limp and four (22%) had gross limitation of function. Avascular necrosis (AVN) was recorded according to Kalamchi and MacEwen criteria. Nine hips (50%) had mild AVN and six (33%) had coxa valga due to lateral physeal arrest.
The radiological outcome at final radiograph was based on Severin grade. Only 4 hips (22%) had a spherical head. Ten hips had moderate deformity (55%) and 5 hips (27%) had aspherical incongruency.
Conclusion: Early and delayed failures in DDH surgery are mainly due to inadequate initial exposure and poor hip stabilization techniques. About 50% of the revision cases had a satisfactory outcome on short term follow-up.
Keywords: Hip, Revision, Surgery, Function, Outcome

References

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How to Cite this Article: Bhaskar | A Functional Outcome after Revision Surgery for Developmental Dysplasia of the Hip (DDH) | International Journal of Paediatric Orthopaedics | May-August 2023; 9(2): 21-26. https://doi.org/10.13107/ijpo.2023.v09.i02.167

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Split Transfer of Tibialis Posterior for Dynamic Equinovarus Deformity in Children with Cerebral Palsy

Functional Outcome after Revision Surgery for Developmental Dysplasia of the Hip (DDH)

Split Transfer of Tibialis Posterior for Dynamic Equinovarus Deformity in Children with Cerebral Palsy

Functional Outcome after Revision Surgery for Developmental Dysplasia of the Hip (DDH)

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Split Transfer of Tibialis Posterior for Dynamic Equinovarus Deformity in Children with Cerebral Palsy

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(Article Text HTML) (Full Text PDF)

Functional Outcome after Revision Surgery for Developmental Dysplasia of the Hip (DDH)

Abstract

(Article Text HTML) (Full Text PDF)

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