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Surgical Correction of Telipis Equinovarus in Children with Cerebral Palsy and Poliomyelitis

Objective: The purpose of this study was to evaluate the result of percutaneous tendo-achilles lengthening as treatment for equines deformity in children with cerebral palsy and poliomyelitis. Study design: Descriptive Retrospective study. Materials and Methods: This descriptive retrospective study was carried out in the department of pediatric surgery, the children’s hospital, PIMS, Islamabad for three years from June 2008 to June 2011. Children who were under 12 years of age with cerebral palsy and poliomyelitis having tendo-achilles shortening were included. Patients with varus deformity were excluded from the study. Twenty three patients out of them 14 having cerebral palsy and 9 having poliomyelitis were included in the study. Percutaneous tendo achilles lengthening was performed in all these patients. These patients were followed up for the next 3 to 12 months. Outcome of surgery was assessed on a pre-defined scale. Results: Out of twenty three cases fourteen were of cerebral palsy and remaining nine had poliomyelitis. Over male to female ratio of total 23 cases, 16(69.5%) were male and 7 (30.5%) were female. The mean age of the patients was 7.6 years (range 3 to 12 years). Patients were followed up for the next 3 to 12 months. Out of total patients, 4 developed superficial wound site infection, 2 presented with recurrence and 2 cases failed to appear in follow up. We had outstanding results in 13 (56.5%) cases, 7 (30.4%) cases showed good result, result of 1 (4.3%) case was satisfactory and in 2 (8.7%) cases results were poor Conclusions: Our conclusions were that elongation of tendo Achilles is a single stage operative procedure of choice without any significant risk to the patients with cerebral palsy and poliomyelitis.