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Results in the treatment of paralytic calcaneus-valgus feet with the Westin technique

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Abstract

Between 1988 and 2003, 23 patients with paralytic calcaneus-valgus feet were submitted to the Westin procedure and 17 patients (25 feet) were re-evaluated. Nine patients were male and eight were female. The mean age at the surgical procedure was 8±5 years. The aetiology of paralysis was sequelae of poliomyelitis in 6 patients (8 feet) and of myelomeningocele in 11 patients (17 feet). The mean follow-up period was 6±6 years. The results were analysed clinically and radiographically considering the decrease of the retropulsion, the patient’s satisfaction, and the increase of the lateral tibiocalcaneal angle. Results were considered satisfactory when the patients showed a decrease of the retropulsion during gait, improvement of the gait pattern, and an increase of the tibiocalcaneal angle. As an overall result, 16 patients (94.2%) were satisfied and 1 patient (two feet) dissatisfied with the outcome. The increase of the tibiocalcaneal angle was significant for the myelomeningocele patients (P=0.001), but not for poliomyelitis (P=0.053). No statistical relation between the follow-up period and the increase of the tibiocalcaneal angle was found (r=0.04). The authors concluded that the Westin procedure is a good technique for the treatment of paralytic calcaneus valgus feet with myelomeningocele.

Résumé

Entre 1988 et 2003, 23 patients présentant un pied valgus paralytique ont été traités par le procédé de Westin et 17 patients (25 pieds) ont été évalués. Neuf patients étaient de sexe masculin et huit de sexe féminin. L’âge moyen à l’intervention a été de 8 ans ±5 ans. L’étiologie de la paralysie était surtout une séquelle de polio dans six cas (8 pieds), un myéloméningocèle chez 11 patients (17 pieds). Le suivi moyen a été de 6 ans ±6. Les résultats ont été analysés cliniquement et radiographiquement. Les résultats ont été considérés comme satisfaisants lorsque les patients ont présenté une diminution de la rétropulsion durant la marche avec une amélioration de la boiterie et une augmentation de l’angle tibiocalcanéen. Seize patients (94.2%) ont été satisfaits et un patient (deux pieds) satisfait. L’augmentation de l’angle tibiocalcanéen a été significatif chez les myloméningocèle (P=0.001) alors qu’il n’était pas significatif sur les pieds polio (P=0.053). Aucune relation statistiquement significative n’a été trouvée entre la période de suivi et l’amélioration de l’angle tibiocalcanéen (r=0.04). Les auteurs concluent que le procédé de Westin est une bonne technique pour le traitement des pieds valgus paralytiques chez le myéloméningocèle.

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Authors and Affiliations

  1. Orthopaedic Department, Santa Casa Medical School and Hospitals, R. Dr. Cesário Motta Jr.,112, 01227-900, São Paulo, Brazil

    Patrícia M. de Moraes Barros Fucs, Celso Svartman, Cláudio Santili, Rodrigo Montezuma C. De Assumpção, Leonardo Felicissimo de Almeida Leite, Leonardo Silva Quialheiro & Sidney de Carvalho Fabricio

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  1. Patrícia M. de Moraes Barros Fucs
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  2. Celso Svartman
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  3. Cláudio Santili
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  4. Rodrigo Montezuma C. De Assumpção
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  5. Leonardo Felicissimo de Almeida Leite
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  6. Leonardo Silva Quialheiro
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  7. Sidney de Carvalho Fabricio
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Correspondence to Patrícia M. de Moraes Barros Fucs.

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Fucs, P.M.M.B., Svartman, C., Santili, C. et al. Results in the treatment of paralytic calcaneus-valgus feet with the Westin technique. International Orthopaedics (SICO 31, 555–560 (2007). https://doi.org/10.1007/s00264-006-0214-8

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  • DOI: https://doi.org/10.1007/s00264-006-0214-8

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