The Ponseti method in the treatment of children with idiopathic clubfoot presenting between five and ten years of age
| Autor: | Bibek Banskota, David Spiegel, T. Rajbhandary, Ashok Kumar Banskota, R. Regmi, O. P. Shrestha |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
Male
musculoskeletal diseases medicine.medical_specialty Clubfoot medicine.medical_treatment Tenotomy Osteotomy Severity of Illness Index Weight-Bearing medicine Humans Orthopedics and Sports Medicine Child Gait Retrospective Studies biology business.industry Forefoot medicine.disease biology.organism_classification Ponseti method Surgery body regions Casts Surgical Valgus Treatment Outcome medicine.anatomical_structure Child Preschool Manipulation Orthopedic Female Ankle business Follow-Up Studies |
| Zdroj: | The Bone & Joint Journal. :1721-1725 |
| ISSN: | 2049-4408 2049-4394 |
| Popis: | Our goal was to evaluate the use of Ponseti’s method, with minor adaptations, in the treatment of idiopathic clubfeet presenting in children between five and ten years of age. A retrospective review was performed in 36 children (55 feet) with a mean age of 7.4 years (5 to 10), supplemented by digital images and video recordings of gait. There were 19 males and 17 females. The mean follow-up was 31.5 months (24 to 40). The mean number of casts was 9.5 (6 to 11), and all children required surgery, including a percutaneous tenotomy or open tendo Achillis lengthening (49%), posterior release (34.5%), posterior medial soft-tissue release (14.5%), or soft-tissue release combined with an osteotomy (2%). The mean dorsiflexion of the ankle was 9° (0° to 15°). Forefoot alignment was neutral in 28 feet (51%) or adducted (< 10°) in 20 feet (36%), > 10° in seven feet (13%). Hindfoot alignment was neutral or mild valgus in 26 feet (47%), mild varus (< 10°) in 19 feet (35%), and varus (> 10°) in ten feet (18%). Heel–toe gait was present in 38 feet (86%), and 12 (28%) exhibited weight-bearing on the lateral border (out of a total of 44 feet with gait videos available for analysis). Overt relapse was identified in nine feet (16%, six children). The parents of 27 children (75%) were completely satisfied. A plantigrade foot was achieved in 46 feet (84%) without an extensive soft-tissue release or bony procedure, although under-correction was common, and longer-term follow-up will be required to assess the outcome. Cite this article: Bone Joint J 2013;95-B:1721–5. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|