Peroneal nerve dysfunction in patients with complex clubfeet

Shinji Yoshioka; Nickolas J Huisman; Jose A Morcuende

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Peroneal nerve dysfunction in patients with complex clubfeet

Journal article

Open access

Peer reviewed

Peroneal nerve dysfunction in patients with complex clubfeet

Shinji Yoshioka, Nickolas J Huisman and Jose A Morcuende

The Iowa orthopaedic journal, Vol.30, pp.24-28

2010

PMCID: PMC2958266

PMID: 21045967

Appears in Diamond Open Access

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url

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2958266/View

Published (Version of record) Open Access

Abstract

Complex clubfeet represent a subset of clubfeet with unique features. Their correction requires a modification of the Ponseti casting technique and good short term results have been reported. However, these clubfeet are very difficult to treat and there is a higher chance for potential complications. We reviewed the database of patients with clubfeet treated from January 2001 to December 2009. There were 837 patients (1376 feet) with 111 (182 feet) (13%) having complex deformity. Of these, 8 patients (10 complex clubfeet) (0.7%) experienced a peroneal nerve dysfunction. Severity of the dysfunction varied from no active dorsiflexion (2 patients) to weakness for active dorsiflexion or foot eversion (6 patients). Deformity correction required an average of 5 casts (range, 1 to 8). Two patients required an Achilles tenotomy and the average ankle dorsiflexion at last follow up was 14 degrees (range: 5 to 25). No surgical releases have been required. Two patients required an ankle foot orthosis to improve gait. There were three relapses (37%) that responded to casting and 1 patient required a tibialis anterior tendon transfer. Only 3 feet have recovered the nerve dysfunction. In conclusion, repeated neurological evaluations and very careful cast placement should be performed during the treatment of complex clubfeet. The modified Ponseti technique, if applied properly, is successful in correcting these feet and avoids extensive surgical releases.

Electromyography

Clubfoot - physiopathology

Severity of Illness Index

Humans

Child, Preschool

Infant

Male

Treatment Outcome

Peroneal Nerve - physiopathology

Braces

Achilles Tendon - surgery

Tenotomy - methods

Female

Retrospective Studies

Clubfoot - therapy

Casts, Surgical

Details

Title: Subtitle: Peroneal nerve dysfunction in patients with complex clubfeet
Creators: Shinji Yoshioka - The Ponseti Clubfoot Treatment Center, University of Iowa, USA
Nickolas J Huisman
Jose A Morcuende
Resource Type: Journal article
Publication Details: The Iowa orthopaedic journal, Vol.30, pp.24-28
Publisher: Dept. of Orthopaedics, The University of Iowa; United States
PMID: 21045967
PMCID: PMC2958266
ISSN: 1541-5457
eISSN: 1555-1377
Language: English
Date published: 2010
Academic Unit: Stead Family Department of Pediatrics; Orthopedics and Rehabilitation
Record Identifier: 9984040330402771

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