Una entrevista sobre nuestros innovadores tratamientos para los pies con Charcot-Marie-Tooth

Queridos lectores, os traigo aqui la entrevista que me han hecho en la revista CMT Journal, una revista internacional que trata sobre los pacientes que sufren Charcot-Marie-Tooth. Aunque está en ingles se puede leer bastante bien y entender lo que se dice. Para nosotros es un reconocimiento más a nivel internacional a nuestro trabajo para el tratamiento de estos pacientes.

Aqui teneis los links, para ir a la entrevista original y a la revista:




2013-04-03 a la(s) 00.37.44

 I have a confession to make. I spend too much time on the Internet looking for interesting information about Charcot-Marie-Tooth. This activity can be quite frustrating, until I found something worth all these hours at the laptop. Or someone. Or both, like in this article.

But let’s start from the beginning. A few weeks ago I was very surprised to find an English newsletter and an iPhone app, both dedicated to CMT and other reconstructive foot surgeries, and both coming from the same place in Spain: the IICOP Clinic of Madrid.

iTunes has just launched the very first iPhone app in our area, and it hasn’t been developed in Silicon Valley, nor in London, nor Berlin, but in Spain. Sounds very interesting to me. So I started my little investigation, and that’s how I meet our host of today: Dr Fernando Noriega, a Spanish doctor with training experience in the United States and Germany, committed to patients affected by neurological disease such as Charcot-Marie-Tooth, Dejerine-Sottas, sequelae of polio and cerebral palsy.

When he’s not training around the world, Dr. Noriega runs the department of surgery at the International Institute of Orthopaedic Surgery Foot in Madrid. My working summers in Barcellona are a memory of the past, and my Spanish isn’t so good anymore, but the doctor speaks and works in English. Excellent!
I am sure that you will enjoy the interview and his videos. If you want to know more, the contact details of Dr Noriega and the Istitute are at the end of the post. Also, feel free to ask questions in the comment area. I will forward any questions to the doctor. I promise!
* * *
Dr. Noriega, could you tell us what is the actual situation of CMT patients in Spain?
In Spain, patient with CMT are, sadly, very neglected. There aren’t many trained orthopedic surgeons who can help them to deal with the consequences of the disease such as foot deformities.

Why would you suggest to a CMT patients to come to your hospital in Madrid?
Our center is highly specialized in the treatment of patients with Charcot-Marie-Tooth. We use innovative techniques of foot reconstruction, which align the foot to be plantigrade (Ed. Meaning that after the surgery the patient walks with the entire sole of the foot on the ground) and we have been improving the walking ability of our patients with excellent results.
Our patients come from all over the Spain and Latin America. Since CMT is often inherited, we have many times treated three, four members of a same family. Thus we have experience with both adult and pediatric patients.

Can you tell us a bit more about foot deformities reconstruction and maybe show us a successful case?
The CMT foot reconstruction procedures are performed by correcting varus equinus foot or cavus varus foot through operations such us fusion of Chopart joint, Lambrinudi’s operations, lengthening and tendons transpositions. In case of CMT where all the muscles are paralyzed, we transfer five tendons at the dorsun of the foot to prevent its fall and avoid the use of antiequinus splints.
Here is a video of a patients with CMT and paralysis of all muscles in his foot. Our surgical treatment has improved his stability and ability to walk without braces.

In this second case, the patients with equinus cavus varus feet as a conseguences of Dejerine-Sottas disease was operated on both feet, with excellent results.

Some doctors we spoke with are against foot surgery. They say it’s jus “cosmetic”: the surgery gives a nicer foot but the patients lose strength because of the forced inaction and pain after a few years. What would you reply to them?
I believe surgery is not just cosmetic: it improves function, stability and walking ability of patients affected by CMT. Contrary to popular belief, this disease in adulthood does not progress or progress very little. One observation we have made, is that the loss of muscles strength is not due to the disease, but to the lack of ability to walk or antiequinus splints. When we fix the feet and improve our patients walking ability, they show an improvement in muscular tone and strength.
* * *
For more information, visit Dr. Noriega’s blog in English (www.drfernandonoriega.com), or in Spanish (www.doctorfernandonoriega.com), or his youtube (drfernandonoriega).

Dr. Noriega has also an interesting iPhone and Ipad app. You can find it on iTunes looking for “Footh Ankle”.
Last but not least the Institute.
Instituto International De Cirugia Ortopedica Del Pie
Calle Modesto Lafuente, 59
Madrid, Spain

CMT Journal by Irene Tresca is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 3.0 Unported License. You are free to reproduce this publication for solely non commercial use, under the condition that you attribute the work to CMTJournal.org. For any other use, including commercial, please contact us.
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