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Lateral Column Lengthening as Treatment for Planovalgus Foot Deformity in Ambulatory Children with Spastic Cerebral Palsy

Andreacchio, Antonio M.D.; Orellana, Carlos A. M.D.*; Miller, Freeman M.D.†; Bowen, Thomas R. B.S.‡

Journal of Pediatric Orthopaedics: July/August 2000 - Volume 20 - Issue 4 - pp 501-505
Cerebral Palsy

The purpose of this study was to investigate the effectiveness of lateral column lengthening in the treatment of flexible, planovalgus foot deformity of ambulatory children with spastic cerebral palsy (CP). Fifteen ambulatory children (23 feet) with spastic CP and flexible planovalgus foot deformities received lateral column lengthenings through the calcaneus or calcaneocuboid joint. At an average of 4.1 years of follow-up (minimum, 2.3 years), 17 (74%) feet had good, two (9%) had fair, and four (17%) had poor outcomes. Poor outcomes resulted from recurrence of deformity. Improvements in preoperative, postoperative, and follow-up radiographic measurements were found. However, these improvements are not related to the clinical outcomes. Calcaneal lengthening is a successful treatment for flexible planovalgus foot deformity in ambulatory children with spastic CP. The high failure rate is a significant limitation to the procedure. Further investigation of the objective measurement of planovalgus foot deformity is needed.

Study conducted at the Alfred I. duPont Hospital for Children, Wilmington, Delaware, U.S.A.

From the Pediatric Orthopaedic Department, C. Arrigo Children's Hospital, Alessandria, Italy; *Orthopaedic Department, Shriners Hospital for Children, Mexico City, Mexico; †Department of Orthopaedic Surgery, Alfred I. duPont Hospital for Children, Wilmington, Delaware, and ‡Jefferson Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, U.S.A.

Address correspondence and reprint requests to Dr. F. Miller, Department of Orthopaedic Surgery, The Alfred I. duPont Hospital for Children, P.O. Box 269, Wilmington, DE 19899, U.S.A. E-mail: fmiller@nemours.org

© 2000 Lippincott Williams & Wilkins, Inc.