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MANAGING ORTHOPAEDIC COMPLICATIONS IN CHARCOT MARIE TOOTH DISEASE
  1. Matilde Laura1,
  2. Gita Ramdharry1,2,
  3. Dishan Singh3,
  4. Mariola Skorupinska1,
  5. Mary Reilly1
  1. 1 National Hospital for Neurology and Neurosurgery
  2. 2 St George's University London/Kingston University
  3. 3 Royal National Orthopaedic Hospital, Stanmore

Abstract

Charcot-Marie-Tooth (CMT) disease is the most common inherited peripheral neuropathy. Foot deformities are frequent complications and orthopaedic surgery is often required. However there are no evidence based guidelines on the type or timing of the surgery. Evidence regarding optimal surgical management of these patients is lacking.

Aims To prospectively study surgical management of CMT patients.

Methods Collection of data and assessment of patients before and after surgery.

Data included: history of ankle instability, pain, skin condition, details of physiotherapy and orthotic management, assessment of lower limb strength, Charcot-Marie-Tooth examination score (CMTES), foot posture index, ankle dorsiflexion range of movement, questionnaires (foot index and Manchester-Oxford foot questionnaire, modified fatigue severity scale and modified falls efficacy scale), details of surgical procedures.

Results 16 patients were evaluated prior to surgery, 1 patient was assessed after 1 year, 4 patients after 2 years and 3 patients after 3 years from surgery. A wide range of surgical procedures were performed by one dedicated orthopaedic surgeon. Preliminary results showed improvement of foot alignment and pain after surgery. Analysis of prospective assessments is still ongoing.

Conclusions The results of the study will help developing orthopaedic intervention guidelines and inform questions for further research.

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