Select a Community
Are you sure you want to trigger topic in your Anconeus AI algorithm?
You are done for today with this topic.
Would you like to start learning session with this topic items scheduled for future?
Transfer of peroneus brevis to peroneus longus
9%
124/1402
Split anterior tibial tendon transfer to lateral column
19%
273/1402
Triple arthrodesis
2%
26/1402
Posterior tibial tendon transfer through the interosseous membrane to dorsum of the foot
62%
870/1402
Lateral column lengthening calcaneal osteotomy
7%
96/1402
Select Answer to see Preferred Response
The physical exam and clinical photo are consistent with a cavovarus foot deformity associated with Charcot-Marie-Tooth (CMT) disease. The Coleman block test reveals a flexible hindfoot deformity, which suggests that soft-tissue transfers and not osteotomies can correct the deformity. The posterior tibial tendon retains its strength in CMT and can aid in decreasing hindfoot varus while providing ankle dorsiflexion when transferred to the dorsum of the foot. Wetmore and Drennan evaluated long-term outcomes in patient with CMT who had undergone triple arthrodesis. Nearly fifty-percent of patients had poor outcomes with only 24% having good and excellent results. This led to the recommendation that triple arthrodesis be reserved for a salvage procedure only in patients with CMT. Roper and Tibrewal reviewed long term outcomes in patients with CMT undergoing a variety of soft-tissue procedures. At an average of 14 year follow-up, all 18 feet had avoided the need for triple arthrodesis while continuing to have satisfactory results. Illustration A shows an example of the Coleman block test. This test is used to evaluate for flexibility of the hindfoot varus deformtiy. The illustration shows a flexible deformity with correction of the hindfoot varus. Incorrect Answers: Answer 1: Peroneal longus to brevis transfer can be utilized due to the fact that PL is typically preserved while PB is weakened in CMT. Answer 2: The anterior tibial muscle is weakened and therefore transfer provides no benefit and can actually worsen the deformity. Answer 3: Wetmore and Drennan revealed that poor outcomes are associated with triple arthrodesis in CMT. Answer 5: Lateral column lengthening is used in pes planovalgus foot deformities.
4.1
(21)
Please Login to add comment