Prevalence and orthopedic management of foot and ankle deformities in Charcot-Marie-Tooth disease

Abstract

Introduction: Foot deformities are frequent complications in Charcot-Marie-Tooth disease (CMT) patients, often requiring orthopedic surgery. However, there are no prospective, randomized studies on surgical management, and there is variation in the approaches among centers both within and between countries.

Methods: In this study we assessed the frequency of foot deformities and surgery among patients recruited into the Inherited Neuropathies Consortium (INC). We also designed a survey addressed to orthopedic surgeons at INC centers to determine whether surgical approaches to orthopedic complications in CMT are variable.

Results: Foot deformities were reported in 71% of CMT patients; 30% of the patients had surgery. Survey questions were answered by 16 surgeons working in different specialized centers. Most of the respondents were foot and ankle surgeons. There was marked variation in surgical management.

Discussion: Our findings confirm that the approaches to orthopedic management of CMT are varied. We identify areas that require further research. Muscle Nerve 57: 255-259, 2018.

Keywords: Charcot-Marie-Tooth disease; foot deformities; foot surgery; orthopedic complications; pes cavus; survey.

Figure 1

Paediatric clinical scenario Each column = surgical procedures; Each row represents the procedures chosen by each surgeon; Right hand column = total number of procedures suggested by each surgeon; bottom row = total number of times each procedure was chosen amongst surgeon responders.

Figure 2

Adult clinical scenario. Each column = surgical procedures; Each row represents the procedures chosen by each surgeon; Right hand column = total number of procedures suggested by each surgeon; bottom row = total number of times each procedure was chosen amongst surgeon responders.