F-3-03-03
RECONSTRUCTION WITH TENDON TRANSFERENCE IN PARALYTIC FOOT
Chang Chen-Kuang, M.D. (Hsin Jen General Hospital, Taiwan)
Chao Shang-Liang, M.D. (Cheng Hsin Rehabilitation Center, Taiwan)
Ree Shiao-Jen, M.D. (Hsin Jen General Hospital, Taiwan)
Ko Jyh-Ren, M.D. (Dr. Chang's Rehabilitation Clinic, Taiwan)
Prupose: Foot deformity is commonly seen in poliomyelitis. This report is to study the correction of transfer with various tendons or muscles in its pre-op. evaluation, technique and results.
Method: From 1972 to 1981, 250 patients with foot deformity residued from poliomyelitis underwent 325 tendon transfers with the age range from 5 to 22 year-old (av.13 years old). Detailed assessment was done including pre-op. deformity, muscle power, R.0.M. and the power after being transferred.
Result: Half of collected cases remained as "good" (49.6%). "Fair" grade is 34.4% and grading "poor" is 16.0%. The most favorable transfer is the peroneous longus tendon to the calcaneous, and the unsatisfied result mainly seen is the posterior tibialis tendon to the dorsum of foot.
Conclusion: 1.Deformity pattern and available tendons: essential in preoperative assessment. 2.The possibility for second surgery with bone stabilization procedure up to 60%.
F-3-03-04
SURGICAL CORRECTION FOR PARALYTIC DEFORMITY OF THE LOWER EXTREMITIES
Hsiung Yung-Wan (Cheng Hsin Rehabilitation & Medical Center, Taipei, Taiwan)
In view of handicapped children in need of medical help Madame Chiang Kai-Shek established the Cheng Hsin Rehab. & Medical Center in Taiwan in May 1967. More than 1,000 patients per year, who have received therapy, are free from all the charges in the Center.
Most patients who have suffered from paralytic deformity over the lower extremities due to sequela of Poliomyelitis, Cerebral Palsy, congenital deformity, etc.. A skeletal deformity may be caused by any one or a combination of any of the following factors; muscle imbalance, unrelieved muscle spasm, habitually faculty posture, dynamics of activity, and growth.
The option of surgical procedures reestablishes joint function including tendon transfer, muscle transplantation, stabilization of relaxed or flail joints with tenodesis. Bony procedures for deformities will be done for skeletally maturity or recurrence after muscle balance procedures. Arthrodesis & corrective osteotomy are indicated for rigid deformities in the lower extremities.
Dynamic balance with function improved of the lower extremities is the goal of surgical procedures. Pain relief with comfortable brace fitting is fundament basic requirement for the treatment of these victims.
