XXXX and @entity18415 associated with cerebral palsy: analysis and treatment.

@entity1 @entity1844 @entity2003 @entity5109 @entity508 @entity18415 @entity4553 @entity1795
@entity4553 and @entity18415 associated with @entity5109 may be due to equinovalgus and/or metatarsus primus adductus or combinations of these. Occasionally the condition occurs in equinovarus feet. @entity4553 " is usually due to a weak @entity2003 longus, overpull of the anterior tibial muscle on the first metatarsal and @entity508 or contracture of the @entity1795 longus or brevis. A weak peroneus longus muscle has not caused this deformity. The condition is usually predictable in the growing @entity1 if all factors related to gait, collagen stability and foot alignment are observed. Treatment includes soft-tissue and bone realignment. Release of the adductor hallucis, lateral collateral ligaments of the metatarsophalangeal joint, plication of the medial capsule and of the abductor hallucis and centralization of the @entity2003 longus will realign the first ray. The @entity1795 longus is transferred to athe @entity2003 longus proximal to the metatarsophalangeal joint and the anterior tibial tendon is transferred to the second metatarsal. An osteotomy at the base of the first metatarsal and at the base of the proximal phalanx will realign the skeleton. Twenty-six great toes in 16 @entity1 have been observed for two to 20 years. The correction has been maintained without arthrodesis of the metatarsophalangeal joint except where @entity1844 occurred. Once the pattern of deformity is evident, progression is unrelenting and treatment is indicated in order to prevent @entity1844 .
