Evelina Children's Hospital, St Thomas Hospital, Westminster Bridge Road, London, UK; King's Foot and Ankle Unit, King's College NHS Foundation Trust, UK.
Evelina Children's Hospital, St Thomas Hospital, Westminster Bridge Road, London, UK.
Foot Ankle Surg. 2022 Jun;28(4):476-482. doi: 10.1016/j.fas.2021.12.009. Epub 2021 Dec 24.
Children with cerebral palsy are highly likely to develop foot deformities, some of which may require surgical intervention. Hallux valgus is a common forefoot deformity which can cause issues with pain, footwear, orthotic splints and soft tissues. It remains unclear what the optimal surgical treatment is for children with cerebral palsy and hallux valgus deformity.
To systematically review studies reporting the clinical and radiological outcomes of surgical correction of hallux valgus deformity in children with cerebral palsy.
A systematic review of studies published in electronic databases (Medline, Embase, Pubmed and Cochrane library) from inception until January 2021. Keywords related to hallux valgus and cerebral palsy were included.
58 studies were identified of which 7 met the criteria for inclusion. 200 feet in 134 patients with a mean age of 13.5 years were included, with a mean follow up period of 43 months. A range of clinical and radiographic outcomes were assessed. A treatment framework for the assessment and management of hallux valgus in children with cerebral palsy based on the published evidence is presented.
Non-ambulant children with cerebral palsy with symptomatic hallux valgus should primarily undergo first MTPJ arthrodesis whilst those who are ambulant should undergo first metatarsal osteotomy± soft tissue correction.
脑瘫患儿很可能会出现足部畸形，其中一些可能需要手术干预。踇外翻是一种常见的前足畸形，可引起疼痛、鞋类、矫形夹板和软组织问题。目前尚不清楚脑瘫合并踇外翻畸形患儿的最佳手术治疗方法是什么。
系统回顾报道脑瘫患儿踇外翻畸形手术矫正的临床和影像学结果的研究。
对截至 2021 年 1 月发表在电子数据库（Medline、Embase、Pubmed 和 Cochrane library）中的研究进行系统回顾。纳入与踇外翻和脑瘫相关的关键词。
共确定了 58 项研究，其中 7 项符合纳入标准。共纳入了 134 例患者的 200 只足，平均年龄为 13.5 岁，平均随访时间为 43 个月。评估了一系列临床和影像学结果。根据已发表的证据，提出了一种脑瘫患儿踇外翻评估和管理的治疗框架。
对于有症状的脑瘫非步行患儿，应首先行第一跖趾关节融合术，而对于可步行的患儿，应首先行第一跖骨截骨术+软组织矫正术。
