Surgical Outcomes in Patients with Toe Walking after Percutaneous Myofasciotomy: Cohort Study
https://doi.org/10.15690/pf.v19i2.2408
Abstract
Background. The main method of surgical treatment of toe walking is Achilles tendon extension, which is associated with the risk of excessive correction, tendon rupture, its poor blood supply, plantar flexion deformity. Another alternative is minimally invasive technique, myofasciotomy.
Objective. The aim of the study is to study the results of percutaneous myofasciotomy in patients with idiopathic toe walking with severe foot deformity and with no effect of conservative therapy.
Methods. The study included data (medical records) from patients with idiopathic toe walking who underwent Ulzibat percutaneous myofasciotomy. We have evaluated the frequency of persistence (recurrence) of toe walking on the next day and 12 months after surgery among all the treatment outcomes. Additionally, the range of motions in ankle joint, the presence of foot deformities, parental satisfaction with surgery results, as well as the number of postoperative complications were analyzed.
Results. Percutaneous myofasciotomy was performed in 50 children (11 females) with median age of 13 (10; 16) years during the study period. There were no cases of toe walking on the next day after surgery. Recurrence of toe walking was revealed in 3 (6%) patients within 12 months after surgery. Dorsiflexion rates reached ≥ 10 degrees in all patients at evaluating foot mobility on the next day after surgery and 12 months later. The only revealed surgical treatment complication was postoperative hematoma in 10 (20%) patients. Parents of 3 (6%) children (all with recurrent toe walking) were dissatisfied with surgery results.
Conclusion. Ulzibat percutaneous myofasciotomy has shown high efficacy and relative safety in the treatment of patients with idiopathic toe walking.
Supporting agencies: Not specified.
About the Authors
David Pomarino
Praxis Pomarino
Germany
Disclosure of interest:
Germany
Director of the clinic
Hamburg
Disclosure of interest:
David Pomarino — employee of Praxis Pomarino (Hamburg, Germany) that specializes in the diagnosis and management of children with idiopathic toe walking.
Bastian Fregien
Annastift Clinic
Germany
Disclosure of interest:
Germany
Hannover
Disclosure of interest:
Bastian Fregien — employee of Annastift Clinic (Hannover, Germany) that carries out surgical treatment for children with toe walking.
Alexandr Ya. Nazarkin
Institute of Clinical Rehabilitation
Russian Federation
Disclosure of interest:
Russian Federation
Tula
Disclosure of interest:
Alexandr Ya. Nazarkin — deputy general director of Institute of Clinical Rehabilitation (Tula, Russian Federation), center of specialized orthopedic care for patients with congenital and acquired pathology of musculo-skeletal system.
Kevin Rostasy
Center of Pediatric Neurology and Social Pediatrics
Germany
Disclosure of interest:
Germany
Datteln
Disclosure of interest:
Kevin Rostasy confirmed the absence of a reportable conflict of interests.
Anna A. Emelina
Praxis Pomarino
Germany
Disclosure of interest:
Germany
Research Associate
Hamburg
Disclosure of interest:
Anna A. Emelina — employee of Praxis Pomarino (Hamburg, Germany) that specializes in the diagnosis and management of children with idiopathic toe walking.
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Review
For citations:
Pomarino D., Fregien B., Nazarkin A.Ya., Rostasy K., Emelina A.A. Surgical Outcomes in Patients with Toe Walking after Percutaneous Myofasciotomy: Cohort Study. Current Pediatrics. 2022;21(2):125-130. (In Russ.) https://doi.org/10.15690/pf.v19i2.2408
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