关键词: botulinum toxin general practice / family medicine orthopaedics rehabilitation medicine

Mesh : Acetylcholine Release Inhibitors / therapeutic use Botulinum Toxins / administration & dosage therapeutic use Diagnosis, Differential Female Foot / pathology Foot Deformities, Acquired / diagnosis etiology Hemiplegia / complications Humans Middle Aged Muscle Spasticity / complications drug therapy Treatment Outcome

来  源:   DOI:10.1136/bcr-2018-227732   PDF(Sci-hub)   PDF(Pubmed)

Abstract:
A 55-year-old ambulatory woman with hemiplegia and varus foot deformity had several problems in her daily life, including load pain and stance instability in the affected foot, easy fatigue of the non-paralysed leg, low back pain, neck stiffness and rapid shoe-rubber wear on the deformed side. We began repeated focal blockades using botulinum toxin to the tibialis posterior muscle to control varus spasticity. Distant influences presenting in the whole body were relieved soon after the first blockade, and shoe wear also stopped. Although, neither the deformed appearance nor foot contact pattern on walking changed in the initial period after beginning the blockade, the foot contact pattern revealed gradual improvement over several years. Generally, surgical correction is indicated for the treatment of deformed feet. The present case suggests that, in case of varus-deformed foot with some spastic elements, trial of focal blockade for varus spasticity may be worthwhile.
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