The Effects of Split Tibialis Anterior Tendon Transfer to the Peroneus Tertius for Equinovarus Foot in Children with Unilateral Cerebral Palsy: Evaluation with the Edinburgh Visual Gait Score

Öz

This study aimed to objectively evaluate gait quality using the Edinburgh Visual Gait Score (EVGS) after Split Tibialis Anterior Tendon Transfer (STATT) for equinovarus deformity (ED) in children with unilateral cerebral palsy (UCP). Children with UCP who underwent STATT for ED were followed, and data were collected based on the gait observed at the final follow-up. Gait outcomes were assessed using EVGS, and the significance of pre- and postoperative scores was determined. A total of 20 children with UCP were included, with a mean surgery age of 8.3±3.9 years. The mean follow-up period was 43 ± 14 months. Significant improvements were observed in total EVGS scores and specific gait parameters, including initial contact during stance phase, heel lift, maximum dorsiflexion during stance phase, hindfoot varus/valgus position in stance, foot rotation in stance, and maximum ankle dorsiflexion during swing (p <0.001). This study is the first to report the functional outcomes of STATT to the peroneus tertius in children with UCP and ED. Significant improvements in EVGS total scores and specific gait parameters were identified. These findings suggest that STATT improves gait function in children with UCP and may be a valuable surgical approach for managing ED.

Anahtar Kelimeler

• Cerebral palsy
• observational gait analysis
• tibialis anterior
• tendon transfer

Unilateral Serebral Palsi’li Çocuklarda Ekinovarus Ayak Deformitesi için Peroneus Tertius’a Yapılan Split Tibialis Anterior Tendon Transferi’nin Etkileri: Edinburgh Görsel Yürüme Skoru ile Değerlendirme

Öz

Bu çalışma, Unilateral serebral palsili (USP) çocuklarda ekinovarus deformitesi (ED) için uygulanan Split Tibialis Anterior Tendon Transferi (STATT) sonrası yürüme kalitesini Edinburgh Görsel Yürüme Skoru (EGYS) kullanarak objektif olarak değerlendirmeyi amaçlamaktadır. ED nedeniyle STATT ameliyatı geçiren USP’li çocuklar yalnızca takip edilerek değerlendirildi ve veriler son takipteki yürüyüşten toplandı. Yürüme sonuçları EVGS kullanılarak değerlendirildi. Ameliyat öncesi ve sonrası EGYS skorlarının anlamlılığı belirlendi. Toplam 20 USP’li çocuk çalışmaya dahil edildi ve ortalama ameliyat yaşı 8,3±3,9 yıl olarak hesaplandı. Ortalama takip süresi 43±14 aydı. Toplam EGYS skorlarında ve belirli yürüme parametrelerinde anlamlı iyileşmeler gözlendi. Bunlar arasında, duruş fazında ilk temas, topuk kalkma anı, duruş fazındaki maksimum dorsifleksiyon, duruş fazındaki arka ayak varus/valgus durumu, duruş fazındaki ayak rotasyonu ve salınım fazındaki maksimum ayak bileği dorsifleksiyonu yer almaktadır (p <0.001). Bu çalışma, USP’li çocuklarda ED tedavisinde peroneus tertius’a yapılan STATT’nin fonksiyonel sonuçlarını bildiren ilk çalışmadır. EVGS toplam skorlarında ve belirli yürüme parametrelerinde anlamlı iyileşmeler tespit edilmiştir. Bu bulgular, STATT’nin USP’li çocuklarda yürüme fonksiyonunu iyileştirdiğini ve ED yönetimi için değerli bir cerrahi yaklaşım olabileceğini göstermektedir.

Anahtar Kelimeler

• Serebral palsi
• gözlemsel yürüme analizi
• tibialis anterior
• tendon transferi

Kaynakça

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