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Biomedical subjects

F Pecak

Publications and source records attributed to F Pecak.

8 recordsLinked to original sources
PubMed1999

Surgical treatment of clubfoot: the significance of talocalcaneonavicular malposition correction.

In a retrospective study on the surgical management of clubfoot based on clinical and radiographic assessments, 171 feet in 137 patients were reviewed. The surgical procedure was selected according to the degree of the deformity. The more severe cases (group A, 75 feet) were surgically treated according to Turco's one-stage posteromedial release, whereas the milder degrees of deformity (group B, 96 feet) were corrected by elongation of the Achilles tendon with posterior capsulotomy. The mean age of the patients at surgery was 12.5 months in group A and 5.2 months in group B. The mean follow-up time for both groups was 12.2 years. At follow-up, 24 feet (41%) in group A and 52 feet (68%) in group B required repeat surgery. In group A the results were good in 51 feet (68%), fair in 15 (20%), and poor in 9 (12%). In group B, good results were obtained in 44 feet (45%), barely satisfactory results in 25 (27%), and poor results in 27 (28%). It is suggested that the accurate correction of talocalcaneonavicular and calcaneocuboid malposition is a prerequisite for successful surgical treatment of clubfoot. There was a tendency for a better result in group A when the patients were surgically treated between 6 and 12 months of age.

Achilles Tendon↗
PubMed1981

Postural control in scoliosis. A statokinesimetric study in patients with scoliosis due to neuromuscular disorders and in patients with idiopathic scoliosis.

Statokinesimetric characteristics were analysed in patients with scoliosis which had developed in the course of degenerative neuromuscular disorders and in patients with adolescent idiopathic scoliosis. Patients with Duchenne and limb- girdle muscular dystrophy and spinal muscular atrophy showed markedly decreased oscillations of the body's centre of gravity, in addition to a forward shift of its mean position. Thus the postural equilibrium in neuromuscular patients with scoliosis is even more efficiently controlled than normal. On the other hand, patients with idiopathic scoliosis did not show any significant changes as compared with normal subjects. The present study therefore does not support the suggestion that the pathogenesis of scoliosis, at least in neuromuscular patients, is triggered by an impairment of descending postural control.

Adolescent↗
PubMed1980

Scoliosis in neuromuscular disorders.

Hundred-seventy patients with the 4 commonest degenerative neuro-muscular disorders (limbgirdle and Duchenne muscular dystrphy, Kugelberg-Welander's spinal muscular atrophy and peroneal muscular atrophy) were screened for scoliosis, which was found in 56%. Of 76 patients in the early stages of their respective disorders (stages 1-6 of Gardner-Medwin and Walton), scoliosis was found in 72%. The incidence of scoliosis was not related to the duration or degree of clinical weakness. Morphologically, scoliosis in these disorders was not found to differ from idiopathic scoliosis. Neither side nor site of the scoliosis were related to the distribution of muscle weakness as determined by manual testing.

Humans↗
PubMed1979

Segmental neurophysiological mechanisms in scoliosis.

Segmental spinal reflexes (stretch reflexes) were studied in patients with scoliosis. The proprioceptive responses to the phasic stretch of the paraspinal muscles were asymmetric in all patients, and were increased on the convex side. The asymmetry was more pronounced when the patients were standing. The observed asymmetry of the reflex responses was taken to indicate asymmetry in the tone and postural activity of the superficial layer of the paraspinal muscles. A reciprocal relationship was found in the segmental reflex organisation between the superficial and deep layers of the paraspinal muscles. The increase in reflex response of the superficial muscles on the convex side can be due to diminished reciprocal inhibition from weak, deep muscles. Thus a segmental neurogenic disorder involving predominantly the deep paraspinal muscles of the convexity of the curve may be the primary lesion responsible for the development of scoliosis.

Adolescent↗
PubMedDate not supplied

Histochemistry of abductor hallucis muscle in children with idiopathic clubfoot and in controls.

The histochemical composition of the abductor hallucis (AH) muscle was investigated in 39 children with idiopathic clubfoot (CF), aged 0-11 years, and in 42 controls. In the youngest group of patients (0-2 years) the percentage of type 1 (slow twitch, tonic) fibers was significantly higher than in controls. In older groups, there was no difference between patients and controls. The relative predominance of type 1 fibers could be due to immobilization, passive shortening or stretching, or primary overactivity of this muscle in CF promoted by an unknown neural factor. None of these interpretations could be proven.

Biopsy↗
PubMedDate not supplied

Treatment of resistant idiopathic pes equinovarus: ten-year experience.

Fifty cases of clubfeet (38 children) were evaluated 10 years after surgery. Turco's method was used in 22 cases, while 24 were managed with Achilles tendon lengthening and dorsal capsulotomy. After Turco's operation, good results were achieved in 69% and the deformity recurred in 31%. In the second group, the success rate was 63%. Recurrences are due to insufficient reduction of the talocalcaneonavicular joint. The authors conclude that Achilles tendon lengthening and posterior capsulotomy should be carried out by age 4 months. If by the age of 1 year the foot has not yet assumed its normal position, complete operative reduction is recommended. Preliminary results of histochemical studies of the peroneal muscles are presented.

Arthroplasty↗