August is Spinal Muscular Atrophy Month, so today we want to talk a little about foot surgeries on individuals affected by muscular dystrophy – a form of SMA. Interestingly, a recent study found that treatment options and surgical techniques for foot deformities in individuals with SMA vary significantly. Is that because each case is so unique that a standard approach wouldn’t do much good, or are we just lacking in creating a standard protocol for these individuals? Let’s take a look.
The study, which will be published in Muscle and Nerve, examined the management techniques for individuals with foot and ankle deformities caused by the underlying condition Charcot Marie Tooth disease. CMT disease is an inherited motor and sensory nerve disorder that causes progressive muscle tissue and sensation loss in certain areas of the body. Oftentimes the feet and ankles are affected by this condition, but if it’s caught early enough or it is a lesser form of the condition, surgery may not be necessary. You may find relief from conservative care techniques like physical therapy, bracing and other assistive devices. For others, surgery is necessary. But treatment techniques vary widely, according to the study.
Foot Deformity Study Results
In a study of more than 2,700 individuals with CMT, researchers found that more than 70 percent of them had foot deformities. However, their treatment methods varied widely.
- 30 percent of individuals underwent surgery to correct the deformity.
- 41 percent underwent some other form of conservative treatment, whether it be physical therapy, ankle orthoses or shoe inserts.
- In a survey of 16 surgeons, it took an average of five surgeries to fully fix the deformity if it occurred in a child, and six surgeries if it occurred in an adult.
- Given an identical sample child patient, only two surgeons said they would use the same combination of surgical procedures to correct the child’s foot deformity. None of the 16 surgeons used the same combination of techniques on a hypothetical adult patient.
Researchers concluded that the findings “highlight the need for further research and the need for guidelines for foot surgery which should include indications for and timing of surgery, type of surgery and guidance for follow-up.”
So while we don’t have a clear answer as to why there isn’t a more standard surgical approach, it’s clear that we should work towards researching the best techniques so we can standardize an approach for certain individuals who meet specific criteria. No two patients are the same, but if they are expressing similar symptoms and characteristics and we’ve developed surgical techniques that provide better outcomes for these individuals, we should be following through with specific operative techniques that give them the absolute best chance of a successful surgery.
