NDLI: Minimally Invasive Early Operative Treatment of Progressive Foot and Ankle Deformity Associated With Charcot-Marie-Tooth Disease.

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Minimally Invasive Early Operative Treatment of Progressive Foot and Ankle Deformity Associated With Charcot-Marie-Tooth Disease.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Boffeli, Troy J. Tabatt, Jessica A.
Description	Country affiliation: Mongolia Author Affiliation: Boffeli TJ ( Director, Foot and Ankle Surgical Residency Program, Regions Hospital, HealthPartners Institute for Education and Research, St Paul, MN.); Tabatt JA ( Resident, Foot and Ankle Surgery Residency Program, Regions Hospital, HealthPartners Institute for Education and Research, St Paul, MN. Electronic address: Jessica.A.Tabatt@healthpartners.com.)
Abstract	Charcot-Marie-Tooth disease is a neuromuscular disorder that commonly results in a predictable pattern of progressive bilateral lower extremity weakness, numbness, contracture, and deformity, including drop foot, loss of ankle eversion strength, dislocated hammertoes, and severe cavus foot deformity. Late stage reconstructive surgery will be often necessary if the deformity becomes unbraceable or when neuropathic ulcers have developed. Reconstructive surgery for Charcot-Marie-Tooth deformity is generally extensive and sometimes staged. Traditional reconstructive surgery involves a combination of procedures, including tendon lengthening or transfer, osteotomy, and arthrodesis. The described technique highlights our early surgical approach, which involves limited intervention before the deformity becomes rigid, severe, or disabling. We present 2 cases to contrast our early minimally invasive technique with traditional late stage reconstruction. Charcot-Marie-Tooth disease affects different muscles at various stages of disease progression. As 1 muscle becomes weak, the antagonist will overpower it and cause progressive deformity. The focus of the early minimally invasive approach is to decrease the forces that cause progressive deformity yet maintain function, where possible. Our goal has been to maintain a functional and braceable foot and ankle, with the hope of avoiding or limiting the extent of future major reconstructive surgery. The presented cases highlight the patient selection criteria, the ideal timing of early surgical intervention, the procedure selection criteria, and operative pearls. The early minimally invasive approach includes plantar fasciotomy, Achilles tendon lengthening, transfer of the peroneus longus to the fifth metatarsal, Hibbs and Jones tendon transfer, and hammertoe repair of digits 1 to 5.
File Format	HTM / HTML
ISSN	10672516
Issue Number	4
Volume Number	54
e-ISSN	15422224
Journal	The Journal of Foot and Ankle Surgery
Language	English
Publisher	Elsevier
Publisher Date	2015-07-01
Publisher Place	United States
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Orthopedics Discipline General Surgery Charcot-marie-tooth Disease Surgery Minimally Invasive Surgical Procedures Achilles Tendon Adolescent Adult Arthrodesis Disease Progression Foot Joints Hammer Toe Syndrome Humans Joint Capsule Release Male Tendon Transfer Case Reports Journal Article
Content Type	Text
Resource Type	Case study Article
Subject	Orthopedics and Sports Medicine Surgery

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