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Effects of myelomeningocele in the ankle after Westin tenodesis

OBJECTIVE: To evaluate the increased fibular growth in patients with myelomeningocele sequelae with deformities in calcaneus foot and ankle valgus submitted to Westin tenodesis. METHODS: The study evaluated six patients (12 feet) with myelomeningocele sequelae, ambulant, submitted to tenodesis of the calcaneus tendon in the fibula, with transbone stitches following the technique that was originally described by Westin, from January 1996 to December 2000. RESULTS: Analysis of the results of the intermaleolar height difference presenting calcaneus foot deformity and submitted to surgical treatment with calcaneus tendon tenodesis according to the Westin technique showed a major growth of the lateral malleolus when compared to pre-operative measurements (p < 0.05). Results also show that the lateral malleolus growth is not related to the patient age when he or she was submitted to surgery. All of the six patients presented different growth patterns along the follow-up. When the authors evaluated the correction of the valgus angle in the ankle, they found a decrease of the angle, with partial or total correction of the deformity (p < 0.05). CONCLUSION: Results show that growth of the lateral malleolus does occur in calcaneus tendon tenodesis following the Westin technique in patients with myelomeningocele sequelae due to the growth stimulus of the tendon in the fibula. However, such growth is not related to the age in which the patient was submitted to surgery. There was a concomitant correction of the valgus angle of the ankle joint.

Meningomyelocele; Tenodesis; Ankle; Orthopedic procedures


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