Early results of surgical treatment of the pes equinovarus (PEV) deformity in the patients with meningomyelocele

Pes equinovarus is the most common foot deformity in the patients with spina bifida. The treatment of the equinovarus deformity in these patients differs from the treatment of idiopathic clubfoot because of its rigidity and the high recurrence rate after the conservative treatment. The aim of this retrospective study is to evaluate the early functional and clinical results after the surgical treatment of the clubfoot in the spina bifida patients. MATERIAL AND METHODS Between August 2014 and November 2016, 39 feet with equinovarus deformity of the 29 spina bifida patients with the history of failed conservative treatment underwent surgical treatment with posteromedial release in our clinic. The feet are divided in groups on their neurological lesion. The preoperative and postoperative functional capacity of the patients were assessed with the GMFCS and FMS and the results were assessed. RESULTS The avarage follow-up period was 15,62 months (2-27). 39 feet of 29 patients, 18 male (62,07%) and 11 female(37,93%), with the average age of 5,45(2-13) were included in this study. There were 21 right feet(53,85%) and 18 left feet(46,15%). 19 (%65,12) of 29 patients had unilateral deformity and 10 patients(34,48%) had bilateral deformity. The feet (n=39) of the 29 patients were divied to groups based on the Sharrard classification and the groups had 4 thoracic lesion(10,26%), 14 high lumbar lesion(35,90%), 16 low lumbar(41,03%) and 5 sacral lesion(12,82%). There was not statitistically significant change was obtained in the thoracic lesion group in the results of both preoperative and postoperative GMFCS and FMS scores.(p=1) There was statitistically significant improvement was obtained in the results of both postoperative GMFCS and FMS scores of the high lumbar, low lumbar and sacral groups. (p<0,05) CONCLUSION In this study, the improvements were observed in the functional and clinical results of the spina bifida patients after the surgical treatment of the pes equino varus deformity in the short term follow-up.