Subjective outcome of reconstruction of the adult acquired neurological equinovarus foot.

A retrospective study was done of the subjective outcome of surgical correction of a spastic equinovarus foot deformity in 27 adult patients with acquired spastic hemiplegia. The mean age of the patients was 49 years and the mean follow-up period was 29 months. The patients were submitted to individualized soft-tissue surgery intended to correct their deformities and rebalance the affected joints, and subsequently subjected to a standard rehabilitation protocol. The assessment was based on the clinical records and on a questionnaire sent to the patients about relevant aspects of their gait, lifestyle and untoward effects and complications. The results have shown that patients experience frank improvement in terms of gait, orthostatic posture, self-esteem and quality of life. Transient or permanent adverse effects occurred in 11 of the 27 patients. The changes induced by surgery to reduce the imbalance and deformity of the foot have a considerable impact on independence and quality of life of these patients despite the high rate of complications.