Research Article
Volume 12 Issue 10 - 2021
Role of Plantar Aponeurosis in the Formation of Cavus Component in Recurrent Congenital Talipes Equinovarus
Kykosh Gennadiy Viktorovich1*, Khmyzov Serhiy Oleksandrovych2 and Karpinsky Michael Yuriiovych3
1Candidate of Medical Sciences, Researcher of the Department of Pediatric Pathology of Spine and Joints of the State Institution “Sytenko Institute of Spine and Joint Pathology NAMS of Ukraine”, Ukraine
2Doctor of Medical Sciences, Professor, Head of the Department of Pediatric Pathology of Spine and Joints of the State Institution “Sytenko Institute of Spine and Joint Pathology NAMS of Ukraine”, Ukraine
3Researcher of the Laboratory of Biomechanics of the State Institution “Sytenko Institute of Spine and Joint Pathology NAMS of Ukraine, Kharkiv, Ukraine
*Corresponding Author: Kykosh Gennadiy Viktorovich, Candidate of Medical Sciences, Researcher of the Department of Pediatric Pathology of Spine and Joints of the State Institution “Sytenko Institute of Spine and Joint Pathology NAMS of Ukraine”, Ukraine.
Received: August 25, 2021; Published: September 30, 2021




Abstract

Introduction: Congenital talipes equinovarus (CTEV) is the second most frequent among all congenital anomalies of the musculoskeletal system in children, and one of the most common causes of childhood disability in Ukraine. The frequency of CTEV reaches 1 - 3 cases per 1000 newborns (35 - 40% of all foot deformities). According to a number of authors, performing plantar fasciotomy can improve the shape of the foot, weight-bearing and walking functions in patients.

Aim: To determine the role of plantar aponeurosis in the formation of the cavus component in cases of recurrent CTEV in children.

Material and Methods: Mathematical research was carried out using the grapho-analytical method.

Results: In order to lower the foot arch, while correcting its cavus deformity, it is necessary to increase the length of the aponeurosis significantly (up to 25% of its initial length). To perform this task, a significant tensile force should be applied to the aponeurosis. Magnitude of force depends on the level of the foot arch lowering needed. Therefore, to reduce the height of arch by 10 mm, it is necessary to lengthen the aponeurosis by 12 mm, for which purpose a constant force of 932 N must be applied to it. To reduce the height of the foot arch by 20 mm, the magnitude of the tensile force applied to the aponeurosis must be increased to 1438 N, which is almost impossible to implement. Hence, a shortened aponeurosis is a significant obstacle for the effective elimination of cavus foot.

Conclusion:

  1. Plantar aponeurosis plays a direct role in supporting the longitudinal foot arch and is one of the reasons for the persistence of cavus deformity in patients with recurrent CTEV that is not amenable to conservative treatment. To treat the cavus foot, in the absence of the effect of conservative treatment, it is necessary to lengthen it by surgical intervention (transection).
  2. Correction of cavus foot requires a significant lowering of its longitudinal arch, which leads to a significant lengthening of the aponeurosis, up to 25% of its original length.
  3. To ensure an increase in the length of the aponeurosis, it is necessary to have a permanently acting tensile force of a significant magnitude, exceeding 1000 N.
  4. The angle of longitudinal foot arch of 110° can be chosen as a criterion for deciding in favor of preserving or cutting off the aponeurosis.

Keywords: Congenital Talipes Equinovarus; Plantar Aponeurosis

References

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Citation: Kykosh Gennadiy Viktorovich., et al. “Role of Plantar Aponeurosis in the Formation of Cavus Component in Recurrent Congenital Talipes Equinovarus”. EC Orthopaedics 12.10 (2021): 73-84.

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