Correlation between clinical rotational deformities with transverse plane kinematic gait parameters and Ct rotational profile In Spastic Diplegic Cerebral Palsy
Mini-Oral Presentation A2.9
DOI:
https://doi.org/10.14288/hfjc.v14i3.441Keywords:
Torsional Malalignment, Gait, Derotation OsteotomyAbstract
Background: Torsional deformities in lower extremities is common among spastic diplegics. In toeing or out toeing are very often seen. In-toeing is caused by one of the three types of deformity: increased femoral anteversion, internal tibial torsion, and metatarsus varus, while out-toeing, the less common form, is caused by femoral retro-version and external tibial torsion. Purpose: To analyse correlation between rotational deformities on clinical evaluation, Gait study and CT study to ascertain the most reliable parameter for decision making before derotation osteotomy. Methods: Cross sectional data of 50 diplegics with GMFCS 1-3, mean age of 15 years were included. Additionally, 10 segments of post-operative femoral and Tibial derotation osteotomy were evaluated for outcome. Data was evaluated with Pearson’s test. Results: A significant correlation was noted between Clinical Rotations and femoral Anteversion (FAV), Thigh Foot Angle (TFA) and tibial torsion (TT) did not corelate significantly. Significant correlation between Gait parameters and Clinical evaluation was present for TFA and Foot progression angle (FPA) and Hip rotation, while the Pelvic and Knee rotations did not corelate. Between the Gait parameters and CT study no correlation was noted. Comparison of pre and post data showed significant outcome. Conclusions: Static and dynamic evaluations together are important for surgical decision making. Clinically increased IR and FAV does warrant a femoral derotation osteotomy while gait kinematics alone should not be considered. For Tibial derotaation, Kinematics and TFA are more reliable for decision making rather than tibial torsion on CT study.
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Copyright (c) 2021 Mayuri Gad, Chasanal Rathod, Taral Nagda
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