J Korean Foot Ankle Soc.  2004 Jun;8(1):111-113.

Progressive Dynamic Equinovarus Deformity in Hereditary Spastic Paraplegia: A Case Report

Affiliations
  • 1Department of Orthopaedic Surgery, National Medical Center, Seoul, Korea. osnmc@yahoo.co.kr

Abstract

In neurogenic equinovarus deformity, surgical intervention such as tendon transfer or osteotomy can be expected to improve symptoms. However, in rare cases of hereditary spastic paraplegia, the deformity and paralysis gradually progress. So limited operation and early post-operative rehabilitation are preferred to aggressive operation. We would like to report our clinical experience with one case of hereditary spastic paraplegia patient with reference review. A 40 year-old male, given tendon transfer of ankle and foot and tendo achilles lengthening 10 years ago, complained about aggravated spastic paraplegia which resulted in dynamic equinovarus and limited walking ability since his operation. Family history showed limited walking ability of his father with gradually progressing spastic paralysis and he was diagnosed as hereditary spastic paraplegia type I. We had performed a limited operation such as tendo achilles and tibialis posterior lengthening to induce plantigrade standing and walking with crutch. As a result, the patient was able to maintain a stabilized standing posture and walk after the operation. Hereditary spastic paraplegia presents with a progressive paralysis which limits rehabilitation after tendon transfer, and the symptoms can be aggravated. Therefore, considering potential hereditary neurogenic disorders in paients with equinovarus deformity and performing limited operative procedures seem to be important.

Keyword

Hereditary spastic paraplegia; Dynamic Equinovarus deformity; Progressive spasticity

MeSH Terms

Adult
Ankle
Clubfoot*
Congenital Abnormalities*
Fathers
Foot
Humans
Male
Muscle Spasticity
Osteotomy
Paralysis
Paraplegia
Posture
Rehabilitation
Spastic Paraplegia, Hereditary*
Surgical Procedures, Operative
Tendon Transfer
Walking
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