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Functional surgery plus rehabilitation versus physical exercise alone for Charcot-Marie-Tooth cavovarus foot
Zhuoqi Wei1, Zengzhen Cui2, Yuan Cao2
1Peking University Health Science Center, Haidian District, Beijing, China; Department of Orthopaedics, Peking University Third Hospital, Haidian District, Beijing, China.
Background:
Charcot-Marie-Tooth (CMT) cavovarus foot deformity severely impairs walking. This study evaluated walking and functional outcomes in patients managed with functional surgery plus rehabilitation (FS) or physical exercise alone (PE).
Methods:
This retrospective matched cohort study included 109 CMT patients (55 FS, 54 PE) followed for 2 years. Primary outcomes were the 10-Meter and 6-Minute Walk Tests (10MWT, 6MWT). Secondary outcomes included walking disability (Walk-12, FADI), quality of life (SF-12), ankle mobility, and clinical symptoms.
Results:
In the FS group, 10MWT improved significantly at 6 months, 1 year, and 2 years (all p < 0.05). In the PE group, 10MWT improved significantly only at 6 months. 6MWT improved significantly in both groups at all follow-up points. At 2 years, the FS group showed significant reductions in falls (-21.8%; p = 0.019), callus formation (-16.4%; p = 0.026), and mobility aid use (-25.4%; p = 0.002), whereas the PE group showed no significant changes in these symptoms. CMTES remained unchanged in both groups.
Conclusions:
In appropriately selected patients with CMT-related foot deformity, both treatments improved walking function in the short term. FS was also associated with sustained reductions in falls, calluses, and mobility aid use at 2 years, whereas PE showed no significant changes in these symptoms.