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Morbus Charcot-Marie-Tooth - options for orthopedic treatment of deformities of the foot

Publication at Second Faculty of Medicine |
2015

Abstract

Charcot-Marie-Tooth disease is a genetically determined polyneuropathy presenting with muscle imbalance and contractures. It is often associated with bone and joint deformities of the feet and hands.

The progress of the disease is very individual and clinical pictures can vary even within a single family, with some CMT individuals being almost asymptomatic while others being quite severely affected. CMT diagnosis is based on electromyographic studies and DNA analysis.

Curative therapy is unknown. Symptomatic therapy involves medication, rehabilitation, prosthetic care and orthopaedic surgical procedures depending on actual clinical picture, subjective symptoms and progression.

Orthopaedic surgical treatment mostly concerns feet deformities. Depending on clinical picture and imaging studies, soft tissue, bone and/or joint procedures can be done.

Surgical treatment approach must be strictly individual based on expected progression of the disease. Our surgical treatment approach is to start with easier procedures done on soft tissues or simple osteotomies, later more complicated joint procedures and finally arthrodesis is often indicated.

It is advisable to proceed step by step aiming for maximum bone and joint deformity correction within one surgical procedure.