alexa Split Anterior Tibialis Tendon Transfer (Splatt) and Achilles Tendon Lengthening for The Correction of The Varus Foot after Stroke a Prospective Longitudinal Study | Abstract
ISSN: 2329-9096

International Journal of Physical Medicine & Rehabilitation
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Research Article

Split Anterior Tibialis Tendon Transfer (Splatt) and Achilles Tendon Lengthening for The Correction of The Varus Foot after Stroke a Prospective Longitudinal Study

Thierry Deltombe1*, Philippe Decloedt2, Jacques Jamart3, Delphine Costa1, Pauline Leboul1 and Thierry Gustin4

1Department of Physical Medicine and Rehabilitation, CHU Dinant , Godinne / UCL Namur (Université catholique de Louvain), B-5530 Yvoir, Belgium

2Department of Orthopaedic Surgery, CHU Dinant , Godinne / UCL Namur (Université catholique de Louvain), B-5530 Yvoir, Belgium

3Department of Scientific Support Unit, CHU Dinant , Godinne / UCL Namur (Université catholique de Louvain), B-5530 Yvoir, Belgium

4Department of Neurosurgery, CHU Dinant , Godinne / UCL Namur (Université catholique de Louvain), B-5530 Yvoir, Belgium

*Corresponding Author:
Thierry Deltombe
Department of Physical Medicine and Rehabilitation
CHU Dinant-Godinne / UCL Namur (Université catholique de Louvain)
B-5530 Yvoir, Belgium
Tel: (32) 81 42 37 72
Fax: (32) 81 42 37 79
E-mail: [email protected]

Received Date: March 26, 2014; Accepted Date: April 26, 2014; Published Date: April 28, 2014

Citation: Deltombe T, Decloedt P, Jamart J, Costa D, Leboul P, et al. (2014) Split Anterior Tibialis Tendon Transfer (Splatt) and Achilles Tendon Lengthening for The Correction of The Varus Foot after Stroke a Prospective Longitudinal Study. Int J Phys Med Rehabil S5:006. doi: 10.4172/2329-9096.S5-006

Copyright: © 2014 Deltombe T, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Background: The imbalance between tibialis anterior and peroneus activation in the swing phase of gait after stroke is responsible for an ankle varus leading to foot instability and poor quality of gait. In such case, a split anterior tibialis tendon transfer (SPLATT) procedure is indicated to correct imbalance. The aim of the study was to prospectively evaluate the effect of the SPLATT procedure in varus foot after stroke. Methods: We prospectively evaluated 26 consecutive hemiplegic patients (mean age 48.3 ± 10.2 years) with a varus foot operated for a SPLATT and an Achilles tendon lengthening procedure with a 6 months follow-up. Before and 6 months after surgery, the spasticity (Ashworth scale), muscle strength (MRC scale), active and passive ankle range of motion, gait parameters (10 meter walking test), gait kinematics (video) and need for assistive device were assessed. Results: A decrease in triceps spasticity and an increase in ankle dorsiflexion were observed. The varus in swing and stance phase of gait was improved. After surgery, 90% of the patients didn’t fit their ankle foot orthosis in comparison with 30% before. In contrast, gait speed, proximal spasticity, hip and ankle gait kinematics and need for crutches remained unchanged. Conclusion: This study is the first prospective study using objective validated scales confirming that the SPLATT procedure in combination with Achilles tendon lengthening is able to correct the varus and to reduce the need for orthosis in stroke patients with varus foot. Level of Evidence: Level IV / Prospective longitudinal case series study

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