Neurogene Fu?deformit?ten

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• 作者：Dr. S. Senst (1)
  
• 关键词：Neuroorthop?dische Fu?fehlstellung ; Pes equinus ; Pes equinus valgus ; Pes equinus varus ; Pes plano valgus ; Pes cavus ; Neurogenic foot deformities ; Pes talipes equinus ; Pes equinus valgus ; Pes equinus varus ; Pes plano valgus ; Pes cavus
• 刊名：Der Orthop?de
• 出版年：2010
• 出版时间：January 2010
• 年：2010
• 卷：39
• 期：1
• 页码：31-37
• 全文大小：584KB
• 参考文献：1. D?derlein L, Wenz W, Schneider U (2004) Fu?deformit?ten -Der Spitzfu?/Der Hackenfu?. Springer, Berlin Heidelberg New York
  2. D?derlein L, Wenz W, Schneider U (2002) Fu?deformit?ten -Der Knickplattfu?. Springer, Berlin Heidelberg New York
  3. D?derlein L, Wenz W, Schneider U (2002) Fu?deformit?ten -Der Hohlfu?. Springer, Berlin Heidelberg New York
  4. D?derlein L, Wenz W, Schneider U (1999) Fu?deformit?ten -Der Klumpfu?. Springer, Berlin Heidelberg New York
  5. D?derlein L (2007) Infantile Zerebralparese -Diagnostik, konservative und operative Therapie. Steinkopff, Heidelberg
  6. Pisani G (1998) Fu?chirurgie. Thieme, Stuttgart New York
  7. Niethard FU (1997) Kinderorthop?die. Thieme, Stuttgart New York
  8. Grice DS (1952) An extra-articular arthrodesis of the subastragalar joint for correction of paralytic flat feet in children. J Bone Joint Surg 34 A:927-40
  9. Kr?geloh-Mann I (2008) SCPE (Surveillance of Cerebral Palsy in Europe), neue dt. Aufl. 9/2008. Universit?ts-Kinderklinik, Abt. P?diatrische Neurologie, Tübingen
  
• 作者单位：Dr. S. Senst (1)
  
  1. Orthop?dische Klinik, Abt. f. Kinderorthop?die, Marienstift Arnstadt, Wachsenburgallee 12, 99310, Arnstadt, Deutschland
  

文摘

There is a multitude of neurological diseases which may lead to neuro-orthopaedic problems and subsequently to neurogenic foot deformities. For this reason the diagnostician will be consistently surprised that there is a great multitude of different foot abnormalities and that not only the typical spastic talipes equines dominates. Of particular significance here is that these deformities almost always develop progressively, whereas most diseases persist per se, cerebral palsy being a typical case in point. However, in MMC (myelomeningocele) patients, there is also the danger of a worsening of the basic problem in the case of tethered cord syndrome. Unlike congenital talipes equinovarus, neuro-orthopaedic talipes equinovarus often shows over- or undercorrection postoperatively due to a shift in muscle imbalance. It is important, therefore, that the basis of conservative therapy include regular physiotherapy and orthoses during the day and, if necessary, at night. Botulinum toxin has been established as an additional measure for spasticity; however, this cannot always prevent surgical intervention, but is able to delay this to a better point in the development of the child/patient. The present article describes the diversity of neurological deformities and presents conservative as well as surgical therapeutic approaches.