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2024 | 89 | 1 | 5-18

Article title

Equino-plano-valgus foot in cerebral palsy – clinical principles and surgical techniques review (world perspective). Report from the 5th edition of the Transatlantic Orthopedic Surgery Webinar 2023

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PL
Stopa końsko-płasko-koślawa w mózgowym porażeniu dziecięcym – przegląd zasad klinicznych i technik chirurgicznych (perspektywa światowa). Raport z 5. edycji Transatlantic Orthopedic Surgery Webinar 2023

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Abstracts

PL
Wstęp. Piąta edycja Transatlantic Orthopedic Surgery Webinar 2023 miała miejsce 4 grudnia 2023 roku. Tematem przewodnim webinarium było leczenie stóp końsko-płasko-koślawych u dzieci z mózgowym porażeniem dziecięcym (mpd). W wydarzeniu brali udział prelegenci z Austrii, Australii, Chin, Indii, Kanady, Niemiec, Polski, Szwecji, Turcji, USA i Wielkiej Brytanii.
Wyniki. W pierwszej sesji ogólnej przedstawiono epidemiologię, biomechanikę, funkcję mięśni oraz zasady zapobiegania stopie końsko-płasko-koślawej, zastosowanie testu Silverskiöld w ocenie klinicznej. Omówiono również zasady leczenia deformacji, opcje zaopatrzenia ortotycznego oraz zasady leczenia patologii u osób dorosłych chorujących na mpd. W sesjach chirurgicznych przedstawiono kompleksowo techniki operacyjne leczenia stopy końsko-płasko-koślawej: osteotomię medializującą guz piętowy, osteotomię wydłużającą boczny brzeg stopy z artrodezą skokowo-łódkowatą, wykorzystanie rozszerzalnych implantów (cage) do wydłużenie bocznego brzegu stopy, podwójną artrodezę z przeniesieniem mięśni strzałkowych, przezskórną miofasciotomię z/bez artroerezy, wydłużenie bocznego brzegu stopy z artroerezą, procedurę wg Grice’a z artrodezą skokowo-łódkową, wydłużenie bocznego brzegu stopy z osteotomią kości klinowatej przyśrodkowej wg Cottona, wydłużenie bocznego brzegu stopy z duplikaturą stawu skokowo-łódkowego, artrodezę skokowo-łódkowatą oraz piętowo-sześcienną, transfer mięśnia piszczelowego przedniego na mięsień strzałkowy trzeci. W drugiej sesji ogólnej przedstawiono sposoby oceny wyników leczenia stopy końsko-płasko-koślawej oraz protokoły rehabilitacji pooperacyjnej zakładające pionizację i chodzenie.
Wnioski. Najważniejsze wnioski płynące z wydarzenia to: ocena kliniczna oraz zrozumienie patofizjologii wady jest kluczowe dla jej prawidłowego leczenia, poniżej 6. roku życia rekomenduje się leczenie nieoperacyjne, pomiędzy 6. a 14. rokiem życia przeważają metody chirurgiczne oszczędzające funkcję stawów, po 14. roku życia duża grupa pacjentów wymaga wykonania artrodez stawów, jednak powinno się ich unikać w korektywnych deformacjach oraz u pacjentów z wysokimi wymaganiami funkcjonalnymi. Audytorium webinarium liczyło 583 osoby z 50 krajów. Największa liczba uczestników pochodziła z Polski, Hiszpanii, Turcji i Wielkiej Brytanii.
EN
Introduction. The fifth edition of the Transatlantic Orthopedic Surgery Webinar 2023 occurred on December 4, 2023. The webinar’s main topic was treating equino-plano-valgus foot in children with cerebral palsy (CP). The event included speakers from Austria, Australia, China, India, Canada, Germany, Poland, Sweden, Turkey, the USA and the UK.
Results. The first general session presented epidemiology, biomechanics, muscle function, equino-plano-valgus foot prevention options, and the Silverskiöld test in clinical assessment. It also discussed the principles of deformation treatment, options for orthotic treatment, and pathology treatment in adults suffering from CP. The surgical sessions presented comprehensive surgical techniques for the treatment of clubfoot equinus: sliding calcaneal osteotomy, lateral column lengthening with talonavicular arthrodesis, use of an expandable cage for the lateral column lengthening, double arthrodesis with the transfer of the peroneal muscles, percutaneous soft tissue release with/without arthroereisis, lateral column lengthening with arthroereisis, Grice procedure with talonavicular arthrodesis, lateral column lengthening with medial cuneiform bone plantarflexion osteotomy, lateral column lengthening with duplication of the talonavicular capsule, talonavicular and calcaneocuboid arthrodesis, transfer of the tibialis anterior muscle to the peroneal tertius muscle. The second general session presented methods of assessing the results of clubfoot treatment and postoperative rehabilitation protocols involving upright positioning and walking.
Conclusion. The most important conclusions from the event are: clinical assessment and understanding the pathophysiology of the defect is crucial for its proper treatment; non-surgical treatment is recommended under the age of 6; between the ages of 6 and 14, surgical methods that preserve joint function predominate; after the age of 14 a large percentage of patients require performing joint arthrodesis. Nevertheless, arthrodesis should be avoided to correct flexible deformities and to treat patients with high functional requirements. The webinar audience included 583 people from 50 countries. Most participants came from Poland, Spain, Turkey, and Great Britain.

Year

Volume

89

Issue

1

Pages

5-18

Physical description

Dates

published
2024

Contributors

  • Department of Pediatric Orthopaedics and Traumatology Karol Marcinkowski University of Medical Sciences, Poznań, Poland
  • Department of Pediatric Orthopaedics and Traumatology Karol Marcinkowski University of Medical Sciences, Poznań, Poland
author
  • Schön Clinic, München, Germany
  • Nemours/Alfred I. duPont Hospital for Children, Willmington, DE, USA
  • Orthopaedic Department, Lund University, Lund, Sweden (EACD Education Committee)
  • Rady Children’s Hospital, San Diego, CA, USA
author
  • Department of Pediatric Orthopedics, Hong Kong University, Shenzhen Hospital, China
author
  • GB, Evelina London Children’s Hospital, Guy’s & St Thomas’ NHS Foundation Trust, London, UK
author
  • The Royal Children’s Hospital, Melbourne, Australia
author
  • Ortopediatri Pediatric Orthopedic Academy, Istanbul, Turkey
author
  • Children’s Orthopaedic Centre, Mumbai, India
  • Orthopaedic Hospital Speising, Vienna, Austria
author
  • The Royal Children’s Hospital, Melbourne, Australia
  • SickKids Hospital, Toronto, Canada
author
  • Gillette Children’s Hospital, Saint Paul, MN, USA
  • Department of Pediatric Orthopaedics and Traumatology Karol Marcinkowski University of Medical Sciences, Poznań, Poland

References

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Document Type

Publication order reference

Identifiers

Biblioteka Nauki
31326953

YADDA identifier

bwmeta1.element.ojs-doi-10_31139_chnriop_2024_89_1_1
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