Surgery in advanced Charcot-Marie-Tooth disease

Area of Science:

• Orthopedic Surgery
• Neuromuscular Disorders

Background:

• Charcot-Marie-Tooth disease (CMT) often leads to severe foot deformities, specifically the equinocavovarus position.
• This deformity causes pain, rigidity, and limited mobility, impacting daily activities and work tolerance.

Observation:

• The study details a surgical approach to correct the equinocavovarus foot in advanced CMT.
• Procedures include plantar fasciotomies, osteotomies at metatarsal bases, a Jones procedure with tendon transfer, and arthrodesis of the great toe IP joint.
• Additional procedures like flexor hallucis longus lengthening and capsulotomy may be required.

Findings:

• Ten patients (18 feet) with advanced CMT underwent the described surgical correction.
• Follow-up ranged from 3 to 6 years, demonstrating maintained correction in all cases, including the longest follow-up.
• The surgical goal is to create a plantigrade, flexible, and painless foot.

Implications:

• This surgical technique offers a viable solution for correcting debilitating foot deformities in Charcot-Marie-Tooth disease.
• Successful correction can significantly improve patient ambulation, reduce pain, and enhance overall quality of life.
• The long-term maintenance of correction suggests the durability of the described surgical methods.