Surgical correction of hallux valgus deformity in children with cerebral palsy

Objective: This study aimed to present a treatment algorithm for the correction of the hallux valgus deformity in Cerebral Palsy (CP) patients and to discuss the outcomes based on our clinical and radiological results. Methods: 29 patients (45 feet) were included in the study. The mean age of the pa...

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Main Authors: Ilker Abdullah Sarikaya, Ali Seker, Ozan Ali Erdal, Mehmet Ali Talmac, Muharrem Inan
Format: Article
Language:English
Published: AVES 2018-05-01
Series:Acta Orthopaedica et Traumatologica Turcica
Online Access:http://www.sciencedirect.com/science/article/pii/S1017995X17301207
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author Ilker Abdullah Sarikaya
Ali Seker
Ozan Ali Erdal
Mehmet Ali Talmac
Muharrem Inan
author_facet Ilker Abdullah Sarikaya
Ali Seker
Ozan Ali Erdal
Mehmet Ali Talmac
Muharrem Inan
author_sort Ilker Abdullah Sarikaya
collection DOAJ
description Objective: This study aimed to present a treatment algorithm for the correction of the hallux valgus deformity in Cerebral Palsy (CP) patients and to discuss the outcomes based on our clinical and radiological results. Methods: 29 patients (45 feet) were included in the study. The mean age of the patients at the time of the surgery was 14 (range 6–22) years. The mean follow-up was 33 (range 22–59) months. A reconstructive procedure was performed on 19 patients (27 feet); a soft tissue surgery and exostectomy of the bunion in six patients (11 feet); and MTP joint arthrodesis in four patients (7 feet). The hallux valgus angle (HVA) and the anteroposterior intermetatarsal angle (IMA) were used for radiologic evaluation and the DuPont Bunion Rating Score was used for clinical evaluation. Results: The follow-up period was 36 (range 22–59) months in reconstructive group, 27 (range 24–29) months in soft tissue group, and 29 (range 23–41) months in MTP arthrodesis group. Significant improvements were detected in hallux valgus angle in three groups postoperatively but in soft tissue group correction loss was observed during follow up. Best results were achieved in arthrodesis group and worse in soft tissue group in terms of clinical evaluation. Conclusion: According to our results isolated soft tissue procedures are ineffective in CP patients. Soft tissue procedure combined with metatarsal osteotomy has satisfactory results. Level of evidence: Level IV, therapeutic study. Keywords: Cerebral palsy, Hallux valgus, Surgical treatment, Toe deformity, Hallux valgus algorithm
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spelling doaj-art-7166283c2eaa467dad2f4710fc8c60232025-08-20T03:56:13ZengAVESActa Orthopaedica et Traumatologica Turcica1017-995X2018-05-0152317417810.1016/j.aott.2018.01.008Surgical correction of hallux valgus deformity in children with cerebral palsyIlker Abdullah Sarikaya0Ali Seker1Ozan Ali Erdal2Mehmet Ali Talmac3Muharrem Inan4Ortopediatri Istanbul, Istanbul, TurkeyIstanbul Medipol University Department of Orthopaedics and Traumatology, Istanbul, TurkeyOrtopediatri Istanbul, Istanbul, Turkey; Corresponding author. Dikilitas Mah. Hakki Yeten Cad. No: 10/D Suleyman Seba Kompleksi, Besiktas, 34343, Istanbul, Turkey. Tel.: +90 535 8356626. Fax: +90 212 3121034.Sisli Etfal Training and Research Hospital, Orthopaedics and Traumatology Clinic, Istanbul, TurkeyOrtopediatri Istanbul, Istanbul, TurkeyObjective: This study aimed to present a treatment algorithm for the correction of the hallux valgus deformity in Cerebral Palsy (CP) patients and to discuss the outcomes based on our clinical and radiological results. Methods: 29 patients (45 feet) were included in the study. The mean age of the patients at the time of the surgery was 14 (range 6–22) years. The mean follow-up was 33 (range 22–59) months. A reconstructive procedure was performed on 19 patients (27 feet); a soft tissue surgery and exostectomy of the bunion in six patients (11 feet); and MTP joint arthrodesis in four patients (7 feet). The hallux valgus angle (HVA) and the anteroposterior intermetatarsal angle (IMA) were used for radiologic evaluation and the DuPont Bunion Rating Score was used for clinical evaluation. Results: The follow-up period was 36 (range 22–59) months in reconstructive group, 27 (range 24–29) months in soft tissue group, and 29 (range 23–41) months in MTP arthrodesis group. Significant improvements were detected in hallux valgus angle in three groups postoperatively but in soft tissue group correction loss was observed during follow up. Best results were achieved in arthrodesis group and worse in soft tissue group in terms of clinical evaluation. Conclusion: According to our results isolated soft tissue procedures are ineffective in CP patients. Soft tissue procedure combined with metatarsal osteotomy has satisfactory results. Level of evidence: Level IV, therapeutic study. Keywords: Cerebral palsy, Hallux valgus, Surgical treatment, Toe deformity, Hallux valgus algorithmhttp://www.sciencedirect.com/science/article/pii/S1017995X17301207
spellingShingle Ilker Abdullah Sarikaya
Ali Seker
Ozan Ali Erdal
Mehmet Ali Talmac
Muharrem Inan
Surgical correction of hallux valgus deformity in children with cerebral palsy
Acta Orthopaedica et Traumatologica Turcica
title Surgical correction of hallux valgus deformity in children with cerebral palsy
title_full Surgical correction of hallux valgus deformity in children with cerebral palsy
title_fullStr Surgical correction of hallux valgus deformity in children with cerebral palsy
title_full_unstemmed Surgical correction of hallux valgus deformity in children with cerebral palsy
title_short Surgical correction of hallux valgus deformity in children with cerebral palsy
title_sort surgical correction of hallux valgus deformity in children with cerebral palsy
url http://www.sciencedirect.com/science/article/pii/S1017995X17301207
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