Combined Surgical Technique of Hyperselective and Partial Motor Neurectomies for Spastic Equinus, Equinovarus, and Claw Toe Deformities.

Autor:	Wu KY; From the Division of Plastic Surgery, Mayo Clinic, Rochester, Minn., Pino PA; Hand and Microsurgery, Department of Orthopedic Surgery, Pontificia Universidad Catόlica de Chile, Santiago, Chile., Ryssman DB; Division of Foot and Ankle Surgery, Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minn., Rhee PC; Division of Hand Surgery, Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minn.; Clinical Investigations Facility, Travis Air Force Base, Calif.; Division of Foot and Ankle Surgery, Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minn.
Jazyk:	angličtina
Zdroj:	Plastic and reconstructive surgery. Global open [Plast Reconstr Surg Glob Open] 2024 Nov 12; Vol. 12 (11), pp. e6207. Date of Electronic Publication: 2024 Nov 12 (Print Publication: 2024).
DOI:	10.1097/GOX.0000000000006207
Abstrakt:	Background: Patients with spastic equinus, equinovarus, and claw toe deformities can experience marked pain and functional limitations in the ability to weight-bear comfortably, ambulate efficiently, or mobilize independently. Seen in 80% of patients with cerebral palsy and 18% of patients with stroke (1, 2), the spastic foot and ankle deformities, and its secondary sequelae of static joint contractures, osseous changes, and chronic pain, are unfortunately common. Methods: Adult and pediatric patients undergoing combined hyperselective and selective partial motor neurectomies for varus or claw toe deformities were reviewed. Patient demographics and complications were recorded. Pre- and postoperative Modified Ashworth Scale scores were compared. Results: Twenty-three patients (16 adults and seven pediatric) met inclusion criteria and were included in analysis. At early 6-month follow-up, the mean preoperative Modified Ashworth Score of 2.8 in adult patients and 3.0 in pediatric patients decreased to 0.6 postoperatively. Complications in three adult patients included one patient with temporary dysesthesias to the plantar foot, one with a popliteal abscess requiring incision and drainage, and one superficial wound dehiscence that was managed conservatively. Conclusions: A combined technique of hyperselective and partial motor neurectomies are effective in decreasing tone in the correction of spastic foot and ankle deformities in both adult and pediatric patients in short-term 6-month follow-up. Competing Interests: The authors have no financial interest to declare in relation to the content of this article. Disclosure statements are at the end of this article, following the correspondence information. (Copyright © 2024 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons.)
Databáze:	MEDLINE
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