Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Orthopedic Surgery

Introduction : Planovalgus deformity is a complex three-dimensional malalignmentwhich occurs in 25% of patients with cerebral palsy. It may be caused by spastic peroneal muscles, weakness of the posterior tibialis, or a tight gastrocsoleus, in any combination.After conservative measures have been exhausted, surgical treatment may be considered. One of the surgical options described is arthroereisis. Patients and methods: A prospective case series study conducted which include 40 subtalar joint arthroereisis procedures performed for 21 cerebral palsy patients with planovalgus foot deformity (12 males and 9 females). All cases presented by bilateral symptomatic CP spastic flexible pesplanovalgus and were managed by arthroereisis of the subtalar joint using a Prostop implant at Abo Elreishpaediatric hospital (Faculty of Medicine, Cairo University). The current study started in June 2019 and ended in February 2021. Written detailed informed consents were obtained from parents. Patients' age at the time of surgery ranged from 6 years to 16 years, with a mean of 11.05 years. Follow up duration ranged from 6 months to 21 months with a mean follow up of 12 months. Results:There was a statistically significant decrease of LAT TCA, heel alignment angle and visual analogue pain scale at the 6 months' postoperative follow-up when compared to the preoperative values withP-value less than 0.05. Complications included development of crouch gait, persistent sinus tarsi pain, backed out screw

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