Prevention and correction are the primary measures to take. Drugs may be used to inhibit or decrease hypertonia.
These include the use of botulinum toxin, indicated in patients affected by non-structured focal spasticity secondary to TBI, CVA, multiple sclerosis, spinal injuries and ICP. Passive and active movements of the extremities.
Orthoses, splints or casts may be used in order to:
- benefit the patient functionally
- be personalised
- maintain position
- prevent relapses
Surgery is performed when:
- The deformity is irreducible
- It manifests upon walking.
- It cannot be corrected with splints.
- This is when surgical treatment is proposed.
Preoperative assessment must consider:
- The patient’s status
- The functionality of the foot
- Absence of pressure ulcers
- The patient’s gait
- Whether the deviations are static or dynamic
Indications for surgery:
- Rehabilitation has failed, and all means of correcting the position have failed.
- Reducing, simplifying or facilitating re-education can be achieved.
- There is a psychological, aesthetic or hygienic justification, even if the functional result is poor or null.