샤르코–마리–투스 족부 변형의 진단과 치료의 최신 지견
Current Update in Diagnosis and Treatment of Charcot-Marie-Tooth Foot Deformity
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Charcot–Marie–Tooth (CMT) disease is the most common hereditary peripheral neuropathy, affecting the motor and sensory nerves and manifesting a range of systemic symptoms. CMT disease encompasses a range of genetic subtypes, with symptoms often emerging in childhood and progressing into adulthood. More than 70% of CMT patients exhibit cavovarus foot deformities that impair normal gait, often requiring the use of a brace. A diagnosis relies heavily on a thorough physical examination of each tendon contributing to the deformity. Conservative treatments, such as shoe modifications and braces, are initially preferred. Surgical reconstruction may be considered if conservative management fails. Patients who require surgery typically present with progressive cavovarus deformities, muscular imbalances, soft tissue contractures, and abnormal bone morphology. For a CMT foot reconstruction, joint-sparing surgery with soft tissue release and osteotomy is recommended. Fusion surgery is advised for deformities that are irreducible by joint-preserving surgery or in cases with painful arthritis. CMT foot surgery can enhance the patient’s ability to ambulate without a brace, leading to high satisfaction and improved quality of life.
Abstract
Charcot–Marie–Tooth (CMT) disease is the most common hereditary peripheral neuropathy, affecting the motor and sensory nerves and manifesting a range of systemic symptoms. CMT disease encompasses a range of genetic subtypes, with symptoms often emerging in childhood and progressing into adulthood. More than 70% of CMT patients exhibit cavovarus foot deformities that impair normal gait, often requiring the use of a brace. A diagnosis relies heavily on a thorough physical examination of each tendon contributing to the deformity. Conservative treatments, such as shoe modifications and braces, are initially preferred. Surgical reconstruction may be considered if conservative management fails. Patients who require surgery typically present with progressive cavovarus deformities, muscular imbalances, soft tissue contractures, and abnormal bone morphology. For a CMT foot reconstruction, joint-sparing surgery with soft tissue release and osteotomy is recommended. Fusion surgery is advised for deformities that are irreducible by joint-preserving surgery or in cases with painful arthritis. CMT foot surgery can enhance the patient’s ability to ambulate without a brace, leading to high satisfaction and improved quality of life.
