Original Research
Electromyography Nerve Conduction Velocity Evaluation of Children With Clubfeet
Am J Orthop. 2011 February;40(2):84-86
Author and Disclosure Information
John Thometz, MD, Lance Sathoff, MD, Xue Cheng Liu, MD, PhD, Richard Jacobson, MD, and J. Channing Tassone, MD
Dr. Thometz is Chief of Pediatric Orthopaedic Surgery, Department of Orthopaedic Surgery, Children's Hospital of Wisconsin, Milwaukee, Wisconsin, and Professor, Department of Orthopaedic Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin.
Dr. Sathoff is Past Resident, Department of Orthopaedic Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin.
Dr. Liu is Lab Director, Musculoskeletal Functional Assessment Center, Department of Orthopaedic Surgery, Children's Hospital of Wisconsin, Milwaukee, Wisconsin, and Associate Professor Department of Orthopaedic Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin.
Dr. Jacobson, Department of Neurology, Children's Hospital of Wisconsin, Milwaukee, Wisconsin, and Associate Professor, Department of Orthopaedic Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin.
Dr. Tassone, Department of Orthopaedic Surgery, Children's Hospital of Wisconsin, Milwaukee, Wisconsin, and Associate Professor, Department of Orthopaedic Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin.
Neurologic deficit has been implicated as a possible etiology for clubfoot and a cause for recurrent deformity in patients who have undergone clubfoot surgery.
In the study reported here, we wanted to determine if clubfoot patients with peroneal weakness had any neurologic deficits on electromyography nerve conduction velocity (EMG-NCV) studies before surgery and if there was any association between neurologic deficit and clubfoot recurrence. We reviewed the EMG-NCV studies of 36 patients involving 57 cases of idiopathic clubfoot and recurrence of the deformity or muscle weakness.
In the clubfoot patients with weak peroneal muscle and no prior surgical history, 45% of the studies were interpreted as normal, 20% as neuropathic, 15% as mixed myopathic and neuropathic, 10% as radicular, and 10% as myopathic. In the clubfoot patients with recurrence after clubfoot repair surgeries, 57% had abnormal EMG-NCV studies. Specifically, peroneal mononeuropathy was the most common disorder (41% of clubfoot patients treated surgically).
Awareness of a significant incidence of neurologic deficit may help in preoperative planning by indicating that ultimately a tendon transfer may be necessary to obtain a plantigrade foot.