Surgical Outcomes for Severe Idiopathic Toe Walkers
Autor: | Ashley M Carpenter, Samuel B. Hilton, Alyssa Barré, Addison Brandt, Prabhav Saraswat, Jon R. Davids, David E. Westberry |
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Rok vydání: | 2020 |
Předmět: |
Male
medicine.medical_specialty Adolescent Radiography Walking Plantar flexion 03 medical and health sciences 0302 clinical medicine Humans Medicine Orthopedic Procedures Orthopedics and Sports Medicine In patient Single institution Child Gait Gait Disorders Neurologic Retrospective Studies 030222 orthopedics Movement Disorders business.industry Retrospective cohort study General Medicine Toes Diagnosis of exclusion Surgery Treatment Outcome Lower Extremity Reviewing treatment Pediatrics Perinatology and Child Health Female business |
Zdroj: | Journal of Pediatric Orthopaedics. 41:e116-e124 |
ISSN: | 0271-6798 |
Popis: | Background Idiopathic toe walking (ITW) is a diagnosis of exclusion and represents a spectrum of severity. Treatment for ITW includes observation and a variety of conservative treatment methods, with surgical intervention often reserved for severe cases. Previous studies reviewing treatment outcomes are often difficult to interpret secondary to a mixture of case severity. The goal of this study was to review surgical outcomes in patients with severe ITW who had failed prior conservative treatment, as well as determine differences in outcomes based on the type of surgery performed. Methods After IRB approval, all patients with surgical management of severe ITW at a single institution were identified. Zone II or zone III plantar flexor lengthenings were performed in all subjects. Clinical, radiographic, and motion analysis data were collected preoperatively and at 1 year following surgery. Results Twenty-six patients (46 extremities) with a diagnosis of severe ITW from 2002 to 2017 were included. Zone II lengthenings were performed in 25 extremities (mean age=9.9 y) and zone III lengthenings were performed in 21 extremities (mean age=8.6 y). At the most recent follow-up, 100% of zone III lengthening extremities and 88% of zone II lengthening demonstrated decreased severity of ITW. Six extremities required additional treatment, all of which were initially managed with zone II lengthenings. Conclusions Severe ITW or ITW that has not responded to conservative treatment may benefit from surgical intervention. More successful outcomes, including continued resolution of toe walking, were observed in subjects treated with zone III lengthenings. Level of evidence Level III-case series. |
Databáze: | OpenAIRE |
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