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Doğuştan Çarpık Ayak Tedavisinde Ponseti Yöntemi İle Tedavi Sonuçları

Year 2008, Volume: 5 Issue: 1, 55 - 60, 01.04.2008

Abstract

Amaç: Doğuştan Çarpık Ayak DÇA tedavisinde birçok yöntem tarif edilmiş olsa da Ponseti yöntemi son 10 yılda tekrar gündeme gelmiş ve büyük ilgi görmüştür. Bu çalışmamızda DÇA tedavisinde ponseti yönteminin etkinliği araştırıldı. Çalışma Planı:Çalışmada çarpık ayaklı 24 çocuğun ,31 ayağı 14 erkek,7 kız ; ortalama yaş dağılım 1 gün-7 ay değerlendirildi. Dimeglio’ya göre grade II.,III. ve IV. Deformiteler çalışmaya alındı.19 hastanın 24 ayağı daha önce herhangi bir tedavi görmemişti.5 hastanın 7 ayağında ise başka yerlerde tedavi uygulanmıştı.Hastaların tümüne Ponseti yöntemine uygun olarak elle düzeltme ve alçı uygulandı. Gerektiğinde perkütan aşil tenotomisi %58 uygulandı. Düzelmenin sürmesi ve korunması için ayak abduksiyon ortezi uygulandı. Ortalama takip süresi 16 ay dağılım: 5 ay36 ay idi. Sonuçlar: 21 hastanın 28 DÇA deformitesi %90 ,Ponseti yöntemi ile başarıyla tedavi edildi. 18 hastaya % 58 aşilotomi yapıldı. 3 hasta abduksiyon ortezine uyum gösteremedi ve başarısız sonuç alındı. Çıkarımlar: Ponseti yöntemi ile DÇA tedavisinde %95’ lere varan başarılı sonuçlar bildirilmiştir. Ponseti yöntemi DÇA tedavisinde etkili ve tekrarlanabilir bir yöntemdir.Tedavinin en önemli unsuru alçı sonrası nüksün önlenmesinde abduksiyon ortezini uzun süreli kullanmaktır.Uyum sağlanması için aile eğitilmeli ve kullanılan ayakkabı rahat olmalıdır

References

  • Herring JA, editor: Disorders of the foot.In: Tachdjian’s pediatrics. Vol.2, 3rd.edm Philadelphia: W.B.Saunders; 2002.p.942-59
  • Lynn Staheli,editor.(Çev:Selim Yalçın): Pesekinovarus ponseti yöntemi ile tedavi Global- Help yayınları 2003
  • DimeglioA, Bonnet F,MazeauP,De Rosa V.Orthopaedic treatment and passive motion machine:Consequences fort he surgical treatment of clubfoot.J.Pediatr.Orthop B 1996;5:173-80
  • Mc Kay DW. New concept of and approach to clubfoot treatment :sectionII- correction of the clubfoot J Pediatr Orthop ;3:10-21
  • Napiontek M Clinical and radiographic appearence of congenital talipes equinovarus after succesful nonoperative treatment. J Pediatr Orthop ;16:67-72
  • Simons GW.Complete subtalar release in club feet.partII-Comparison with less extensive procedures.J.Bone Joint Surg(AM) 1985;67:1056- Davies TC,Kiefer G,Zerniche
  • RF.Kinematics and kinetics of the hip,kneeand ankle posteromedial ;21:366-71 with release.J.Pediatr Dimeglio A,Bensahel H,Souchet p,Mazeau P,Bonnet F Classification of clubfoot.J Pediatr Orthop B 1995;4:129-36
  • Ponseti. IV. Common errors in the treatment of congenital clubfoot.Int.Orthop ;21:137-41
  • I.Pes ekino varus tanı ve tedavi uygulamalı kursu (0-6 ay arası) , İ.Ü.İstanbul Tıp Fak. 4-5 Eylül congenital clubfoot.Clin Ortop 1972,(84):23-38 D.Doğuştan tedavisi. ;16:148-59.
  • Ponseti’s vs.Kite’s mehod in the treatment of clubfoot-a prospective randomised study.Int Orthop.2007 Feb 24. of treatment of congenitel clubfoot .J Bone Joint Surg (Am) 1980;10:109-19 idiopathic clubfoot.A thirty-year follow –up note.J
  • Bone Joint Surg (Am) 1995;77:1477-89. tedavisinde Ponseti metodunun erken sonuçları. A.Pesekinovarus(PEV)
  • In: Alpaslan AM,editör.XVII.Ulusal Ortopedi ve Travmatoloji Kongresi Kongre Kitabı ,24-29
  • Ekim 2001;Antalya, Türkiye,2001 İstanbul:Turgut Yayıncılık;2001.s.338-9 ponseti yöntemi ile tedavisi acta Orthop Traumatol Turc 2002,36:281-287
  • S,Ayanoğlu S.Ponseti technique fort he correction of idiopathic clubfeet presenting up to 1 year of age.A preliminary study in children with untreated or complex deformities.Arch Orthop Trauma Surg.2006 Jan;126 (1):15-21..
  • T. Treatment of congenitel clubfoor with the Ponseti method.Zortop Ihre Grenzgeb,2006 Sep- Oct;144(5):497-501. results of the Ponseti method fort he treatment of idiopathic clubfoot.Z Orthop Ihre Grenzgeb.2006 Jan-Feb;144(1):80-6 management of clubfoot in older infants.Clin Orthop Relat.Res.2006 Mar;444:224-8
  • M,Dobbs MB,Morcuende JA.Treatment of the complex idiopathic clubfoot.Clin OrthopRealat Res.2006 Oct;451:171-6 of necleglected idiopathic clubfoot by the Ponseti method.J Mar;89(3):378-81 Surg Br.2007 D,Vasilescu D,Vasilescu of M.Comparative results the Hamzaoğlu A,Daldal F,Tüzün R,Arıtamur
  • A:Doğuştan çarpık ayağın cerrahi tedavisinde CSTR yöntemi; XI.Milli Türk Ortopedi ve Travmatoloji Kongre Kitabı,258.1989 AY,Biçimoğlu komplet olguların klinik ve radyolojik sonuçları.Artroplasti Artroskopik Cerrahi 2001;12:22-31.
  • Effect of cast removal timing in the correction of idiopathic clubfoot by the ponseti method.Iowa Orthop J.2007;27:24-7
  • R,Herzenberg JE, Ganger R,Gril F.Radiographic evaluation of idiopathic clubfeet undergoing ponseti treatment. J.Bone Joint Surg Am2007 Jun;89(6):1177-83. in the Ponseti method for idiopathic clubfoot deformity:torsional deformities and compliance.J
  • Pediatr Orthop.2007 Sep,27(6)712-6 MF,Tabak L.Pesekinovarusta subtalar gevşetme uyguladığımız
  • Terrazas –Lafargue G,Morcuende JA. Radler C,Manner HM, Suda R,Burghardt Boehm S,Sinclair M.Foot abduction brace

The Treatment Results Of Ponsetı Method Of Congenıtal Clubfoot

Year 2008, Volume: 5 Issue: 1, 55 - 60, 01.04.2008

Abstract

Objectives:Although several methods were described for congenital clubfoot,ponseti method become more popular in recent decade.In this study of congenital clubfoot,the effectiveness of ponseti method was searched. Methods:During the study 24 children’s 31 feet 14 male,7 female ,average age:2 months 1 day-7 months were evaluated.According to Dimeglio grade II.,III. and IV. Deformities were studied.The 24 feet of 19 patients were never treated before.7 feet of 5 patients were treated in other hospitals.All of these patients were treated again by manipulation method and casting in accordance with the Ponseti method.Whenever it was needed percutaneous Achilles tenotomy %58 was performed.Maintance of correction was obtained with the use of a foot abduction orthosis.The avarage follow-up period was 16 months. range 5 months to 36 months . Results: 28 deformitted feet of 21 patients were treated succesfully by using the Ponseti method.18 patients %58 were performed Achilles tenotomy.3 patients couldn’t be complianced foot abduction orthosis application and resulted with failure. Conclusion:It was reported the success result of the ponseti method in congenital clubfoot treatment,was %95.The Ponseti method is an effective and re used tecnique in congenital clubfoot treatment.The most important factor is that after casting the prevent of recurrence the long-term use of abduction orthosis.The family must be educated and the shoe of orthosis must be comfortable in order to be compliance of the patient

References

  • Herring JA, editor: Disorders of the foot.In: Tachdjian’s pediatrics. Vol.2, 3rd.edm Philadelphia: W.B.Saunders; 2002.p.942-59
  • Lynn Staheli,editor.(Çev:Selim Yalçın): Pesekinovarus ponseti yöntemi ile tedavi Global- Help yayınları 2003
  • DimeglioA, Bonnet F,MazeauP,De Rosa V.Orthopaedic treatment and passive motion machine:Consequences fort he surgical treatment of clubfoot.J.Pediatr.Orthop B 1996;5:173-80
  • Mc Kay DW. New concept of and approach to clubfoot treatment :sectionII- correction of the clubfoot J Pediatr Orthop ;3:10-21
  • Napiontek M Clinical and radiographic appearence of congenital talipes equinovarus after succesful nonoperative treatment. J Pediatr Orthop ;16:67-72
  • Simons GW.Complete subtalar release in club feet.partII-Comparison with less extensive procedures.J.Bone Joint Surg(AM) 1985;67:1056- Davies TC,Kiefer G,Zerniche
  • RF.Kinematics and kinetics of the hip,kneeand ankle posteromedial ;21:366-71 with release.J.Pediatr Dimeglio A,Bensahel H,Souchet p,Mazeau P,Bonnet F Classification of clubfoot.J Pediatr Orthop B 1995;4:129-36
  • Ponseti. IV. Common errors in the treatment of congenital clubfoot.Int.Orthop ;21:137-41
  • I.Pes ekino varus tanı ve tedavi uygulamalı kursu (0-6 ay arası) , İ.Ü.İstanbul Tıp Fak. 4-5 Eylül congenital clubfoot.Clin Ortop 1972,(84):23-38 D.Doğuştan tedavisi. ;16:148-59.
  • Ponseti’s vs.Kite’s mehod in the treatment of clubfoot-a prospective randomised study.Int Orthop.2007 Feb 24. of treatment of congenitel clubfoot .J Bone Joint Surg (Am) 1980;10:109-19 idiopathic clubfoot.A thirty-year follow –up note.J
  • Bone Joint Surg (Am) 1995;77:1477-89. tedavisinde Ponseti metodunun erken sonuçları. A.Pesekinovarus(PEV)
  • In: Alpaslan AM,editör.XVII.Ulusal Ortopedi ve Travmatoloji Kongresi Kongre Kitabı ,24-29
  • Ekim 2001;Antalya, Türkiye,2001 İstanbul:Turgut Yayıncılık;2001.s.338-9 ponseti yöntemi ile tedavisi acta Orthop Traumatol Turc 2002,36:281-287
  • S,Ayanoğlu S.Ponseti technique fort he correction of idiopathic clubfeet presenting up to 1 year of age.A preliminary study in children with untreated or complex deformities.Arch Orthop Trauma Surg.2006 Jan;126 (1):15-21..
  • T. Treatment of congenitel clubfoor with the Ponseti method.Zortop Ihre Grenzgeb,2006 Sep- Oct;144(5):497-501. results of the Ponseti method fort he treatment of idiopathic clubfoot.Z Orthop Ihre Grenzgeb.2006 Jan-Feb;144(1):80-6 management of clubfoot in older infants.Clin Orthop Relat.Res.2006 Mar;444:224-8
  • M,Dobbs MB,Morcuende JA.Treatment of the complex idiopathic clubfoot.Clin OrthopRealat Res.2006 Oct;451:171-6 of necleglected idiopathic clubfoot by the Ponseti method.J Mar;89(3):378-81 Surg Br.2007 D,Vasilescu D,Vasilescu of M.Comparative results the Hamzaoğlu A,Daldal F,Tüzün R,Arıtamur
  • A:Doğuştan çarpık ayağın cerrahi tedavisinde CSTR yöntemi; XI.Milli Türk Ortopedi ve Travmatoloji Kongre Kitabı,258.1989 AY,Biçimoğlu komplet olguların klinik ve radyolojik sonuçları.Artroplasti Artroskopik Cerrahi 2001;12:22-31.
  • Effect of cast removal timing in the correction of idiopathic clubfoot by the ponseti method.Iowa Orthop J.2007;27:24-7
  • R,Herzenberg JE, Ganger R,Gril F.Radiographic evaluation of idiopathic clubfeet undergoing ponseti treatment. J.Bone Joint Surg Am2007 Jun;89(6):1177-83. in the Ponseti method for idiopathic clubfoot deformity:torsional deformities and compliance.J
  • Pediatr Orthop.2007 Sep,27(6)712-6 MF,Tabak L.Pesekinovarusta subtalar gevşetme uyguladığımız
  • Terrazas –Lafargue G,Morcuende JA. Radler C,Manner HM, Suda R,Burghardt Boehm S,Sinclair M.Foot abduction brace
There are 21 citations in total.

Details

Primary Language Turkish
Journal Section Research Article
Authors

Cemil Ertürk This is me

Publication Date April 1, 2008
Published in Issue Year 2008 Volume: 5 Issue: 1

Cite

Vancouver Ertürk C. Doğuştan Çarpık Ayak Tedavisinde Ponseti Yöntemi İle Tedavi Sonuçları. Harran Üniversitesi Tıp Fakültesi Dergisi. 2008;5(1):55-60.

Harran Üniversitesi Tıp Fakültesi Dergisi  / Journal of Harran University Medical Faculty