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Polio - Ankle and Foot

This document discusses poliomyelitis and its effects on the ankle and foot. It outlines various deformities that can result, including equinus, calcaneus, valgus, and varus. Treatment principles involve assessing the deformity and muscle power, preventing worsening during recovery, and using bracing. Surgery may be needed for correction and stabilization, preferably after age 12. Common bony procedures described include subtalar arthrodesis, triple arthrodesis, pantalar arthrodesis, Lambrinudi procedure, posterior bone block, JAPA V-osteotomy, and anterior tarsal wedge osteotomy.

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110 views9 pages

Polio - Ankle and Foot

This document discusses poliomyelitis and its effects on the ankle and foot. It outlines various deformities that can result, including equinus, calcaneus, valgus, and varus. Treatment principles involve assessing the deformity and muscle power, preventing worsening during recovery, and using bracing. Surgery may be needed for correction and stabilization, preferably after age 12. Common bony procedures described include subtalar arthrodesis, triple arthrodesis, pantalar arthrodesis, Lambrinudi procedure, posterior bone block, JAPA V-osteotomy, and anterior tarsal wedge osteotomy.

Uploaded by

Doc Delower
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PPT, PDF, TXT or read online on Scribd
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POLIOMYELITIS

Ankle & Foot

Dr. Md. Iqbal Qavi


Associate Professor of Orthopaedic surgery
NITOR
Normal function of foot depends on –

1. Stability of foot- a) Contour of bone


b) Muscle which control it
c) Integrity of capsule and ligaments

2. Plantegrade weight bearing

3. Absence of any deformity

4. Adequate muscle power


Deformity –

1. Equinus – weakness of dorsiflexors,


aggravated by gravity.
2. Calcaneus – weakness of triceps surae,
usually associated with cavus deformity.
3. Valgus – Usually associated with Tibialis anterior
paralysis, TP may or may not be effected.
4. Varus – Due to weakness of peroneal muscles
with strong TP.
5. Combined – Equino-varus, Equino-valgus,
Calcaneo-cavo-varus, Calcaneo- valgus.
Principles of treatment
 
1. Note deformity and assess muscle power.

1. Note duration – allow recovery and prevent deformity


during period of recovery (1 to 2 years)

3. Prevention of deformity during this period – use brace


a) equines – ankle stop or toe raising spring
b) calcaneal – reverse ankle stop or increased leaver arm
c) valgus or varus – lateral or medial bar with T-strap.

4. Consider surgery – correction of deformity, stabilization


procedure, tendon transfers
Principles of surgery
 
1. It is preferable to delay stabilization and reconstructive
operation until the patient is 12 years old and bone
growth is reaching completion.
2. An exception to this can be made for exra-articular
subtalar arthrodesis – Inversion & eversion can be
sacrificed to achieve stability.
3. Reduction of number of joints in tendon transfer allows
better function.
4. Deformity must be corrected before considering tendon
transfer.
5. Power of muscle to be transferred must be at least 4.
6. Arthrodesis and tendon transfer are preferably done in
two separate sittings, to prevent adhesion of transferred
tendon.
Common bony procedures of foot and ankle –

Stabilization procedures:
1. Extra-articular subtalar arthrodesis (below 12 years)
2. Triple arthrodesis (after 12 yrs)
3. Pantalar arthrodesis – in flial foot
 
Foot drop: lack of available tendon for dorsiflexion 
1. Lambrinudi procedure
2. Posterior bone block
 
For correction of cavus deformity: 
1. JAPA V-osteotomy
2. Anterior tarsal wedge osteotomy
Extra-articular subtalar arthrodesis

Grice & Green Bachalor Modified Bachalor


Foot drop

Lambrinudi procedure Posterior bone block


Correction of cavus deformity

JAPA V-osteotomy Anterior tarsal wedge osteotomy

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