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Outcomes of the congenital clubfoot deformity treated by Ponseti’s method

Year 2011, , 30 - 34, 01.03.2011
https://doi.org/10.5799/ahinjs.01.2011.01.0206

Abstract

Objectives: The purpose of this study was to evaluate our result in patients with congenital clubfoot deformity who had been treated with Ponseti\'s technique. Materials and methods: The study included 28 patients (18 males, 10 females, mean age 2.2 months; range 6 days to 5 months). All patients had Dimeglio grade II, III, and IV deformities. All patients had manipulation and casting according to the Ponseti\'s technique. Achilles tenotomy was performed in the persistent equines. Maintenance of correction was obtained with the use of foot abduction orthosis. Mean follow-up period was 17 months (range 6-36 months). Results: Forty-one feet of 28 patients were treated according to the Ponseti\'s technique. Achilles tenotomy was performed in 31 feet (81%). Posterior release was not performed in any patient. Although, correction was maintained in all feet at the beginning, 14 feet (31%) were relapsed. The relapses were due to decreased compliance to foot abduction orthoses. Conclusion: Ponseti technique is an effective, and reliable in correction of idiopatic congenital clubfoot deformity. The results also suggest that the role of family education to enhance compliance to brace application and experienced orthotist are important to prevent relapses.

References

  • Herring JA (editor). Disorders of the foot. Tachdjian’s Pe- diatricOrthopaedics. Vol. 2, 3rd ed., Philadelphia: WB Saunders, 2002;891-1037.
  • McKay DW. New concept of and approach to clubfoot treatment:section II-correction of the clubfoot. J Pediatr Orthop 1983;3:10-21.
  • Turco VJ. Surgical correction of the resistant club foot. On- estage posteromedial release with internal fixation: a pre- liminaryreport. J Bone Joint Surg [Am] 1971;53:477-497.
  • Carroll NC. Pathoanatomy and surgical treatment of there- sistant clubfoot. Instr Course Lect 1988;37:93-106.
  • Turco VJ. Resistant congenital club foot-one-stage pos- teromedial release with internal fixation. A follow-up re- port of a fifteen-year experience. J Bone Joint Surg [Am] 1979;61:805-814.
  • Uglow MG, Clarke NM. The functional outcome of staged- surgery for the correction of talipes equinovarus. J Pediatr Orthop 2000;20:517-523.
  • Davies TC, Kiefer G, Zernicke RF. Kinematics and kinetic- sof the hip, knee, and ankle of children with clubfoot af- terposteromedial release. J Pediatr Orthop 2001;21:366- 371.
  • Alkjaer T, Pedersen EN, Simonsen EB. Evaluation of thewalking pattern in clubfoot patients who received ear- lyintensive treatment. J Pediatr Orthop 2000;20:642-7.
  • Aronson J, Puskarich CL. Deformity and disability from- treated clubfoot. J Pediatr Orthop 1990;10:109-119.
  • Dimeglio A, Bonnet F, Mazeau P, De Rosa V. Orthopae- dictreatment and passive motion machine: consequences for thesurgical treatment of clubfoot. J Pediatr Orthop B 1996;5:173-180.
  • Laaveg SJ, Ponseti IV. Long-term results of treatment of congenital club foot. J Bone Joint Surg [Am] 1980;62:23- 31.
  • Cooper DM, Dietz FR. Treatment of idiopathic clubfoot. A thirty-year follow-up note. J Bone Joint Surg [Am] 1995;77:1477-1489.
  • Ponseti IV. Treatment of congenital club foot. J Bone Joint Surg[Am] 1992;74:448-454.
  • Dimeglio A, Bensahel H, Souchet P, Mazeau P, Bonnet F. Classification of clubfoot. J Pediatr Orthop B 1995;4:129- 136.
  • Ippolito E, Farsetti P, Caterini R, Tudisco C. Long-term comparative results in patients with congenital clubfoot treated with two different protocols. J Bone Joint Surg Am 2003;85:1286-1294.
  • Catterall A. Early assessment and management of the club foot. In: Benson MK, Fixsen JA, Macnicol MF, Parsch K, editors. Childrenıs orthopaedics and fractures. 2nd ed. London; Churchill Livingstone 2002:464-477.
  • Pirani S, Zeznik L, Hodges D. Magnetic resonance imag- ing study of the congenital clubfoot treated with the Pon- seti method. J Pediatr Orthop 2001;21:719-726.
  • Kite JH. Nonoperative treatment of congenital clubfoot. Clin Orthop 1972;84:29-38.
  • Tümer Y, Biçimoğlu A, Açıkgöz T, Dinçer D. Doğuştan pes ekinovarus’un konservatif tedavisi. Acta Orthop Traumatol Turc 1982;16:148-159.
  • Bursalı A. Pes ekino varus (PEV) tedavisinde Ponseti me- todunun erken sonuçları. In: Alpaslan AM, editör. XVII. Ulusal Ortopedi ve Travmatoloji Kongresi Kongre Kitabı; 24-29 Ekim 2001; Turgut Yayıncılık; 2001:338-339.
  • Herzenberg JE, Radler C, Bor N. Ponseti versus traditional methods of casting for idiopathic clubfoot. J Pediatr Or- thop 2002;22:517-521.
  • Morcuende JA, Dolan LA, Dietz FR, Ponseti IV. Radical reduction in the rate of extensive corrective surgery for clubfoot 2004;113:376-380. method. Pediatrics
  • Dobbs MB, Rudzki JR; Purcell DB, et al. Factors predic- tive of outcome after use of the Ponseti method for the treatment ofidiopathic clubfeet. J Bone Joint Surg Am 2004;86:22-27.
  • Thacker MM, Scher DM, Sala DA, et al. Use of the foot abductionorthosis following Ponseti casts: is it essential? J Pediatr Orthop 2005;25:225-228.
  • Goksan SB. Treatment of congenital clubfoot with Ponseti method. Acta Orthop Traumatol Turc 2002;36:281-287.
  • Varol T, Karakurt L, Belhan O, Tosun BH. Doğustan çar- pık ayaklı olgularda Ponseti Yöntemi ile tedavi sonuçlarımız. Fırat Tıp Dergisi 2008;13:116-119.

Doğuştan çarpık ayaklı olgularda Ponseti yöntemi ile tedavi sonuçları

Year 2011, , 30 - 34, 01.03.2011
https://doi.org/10.5799/ahinjs.01.2011.01.0206

Abstract

Amaç: Bu çalışmanın amacı Ponseti yöntemi ile tedavi ettiğimiz doğuştan çarpık ayaklı (DÇA) olguların sonuçlarını değerlendirmektir. Gereç ve yöntem: Çalışmaya doğuştan çarpık ayaklı 28 hastanın (18 erkek, 10 kız; ortalama yaş 2,2 ay; dağılım 6 gün-5 ay) 44 ayağı alındı. Tüm hastalarda Dimeglio Grade II, III, IV deformite vardı. Tüm hastalara Ponseti yöntemine göre elle düzeltme ve alçı uygulandı. Ekinizmin dirençli olduğu olgulara Aşil tenotomisi yapıldı. Elde edilen düzelmenin korunması için ayak abdüksiyon ortezi kullanıldı. Ortalama takip süresi 17 ay (dağılım 6-36 ay) idi. Bulgular: Yirmi altı hastanın 41 ayağı (% 93) Ponseti yöntemi ile başarıyla tedavi edildi. Otuz altı ayağa (% 81) perkütan aşilotomi uygulandı. Hiçbir ayağa posterior gevşetme uygulanmadı. Tüm ayaklarda başlangıçta düzelme sağlanmasına rağmen, 14 hastada (% 31) nüks görüldü. Nükslerin ortez kullanmaya uyumsuzluktan kaynaklandığı tespit edildi. Sonuç: Ponseti yöntemi, idiyopatik tip DÇA deformitesinde etkili ve güvenilir bir yöntemdir. Nükslerin önlenmesinde, ayak abdüksiyon ortezine uyumu artırmak için aileyi eğitmenin ve ayakkabıyı yapan ortotistin deneyimli olmasının önemli olduğu gösterildi.

References

  • Herring JA (editor). Disorders of the foot. Tachdjian’s Pe- diatricOrthopaedics. Vol. 2, 3rd ed., Philadelphia: WB Saunders, 2002;891-1037.
  • McKay DW. New concept of and approach to clubfoot treatment:section II-correction of the clubfoot. J Pediatr Orthop 1983;3:10-21.
  • Turco VJ. Surgical correction of the resistant club foot. On- estage posteromedial release with internal fixation: a pre- liminaryreport. J Bone Joint Surg [Am] 1971;53:477-497.
  • Carroll NC. Pathoanatomy and surgical treatment of there- sistant clubfoot. Instr Course Lect 1988;37:93-106.
  • Turco VJ. Resistant congenital club foot-one-stage pos- teromedial release with internal fixation. A follow-up re- port of a fifteen-year experience. J Bone Joint Surg [Am] 1979;61:805-814.
  • Uglow MG, Clarke NM. The functional outcome of staged- surgery for the correction of talipes equinovarus. J Pediatr Orthop 2000;20:517-523.
  • Davies TC, Kiefer G, Zernicke RF. Kinematics and kinetic- sof the hip, knee, and ankle of children with clubfoot af- terposteromedial release. J Pediatr Orthop 2001;21:366- 371.
  • Alkjaer T, Pedersen EN, Simonsen EB. Evaluation of thewalking pattern in clubfoot patients who received ear- lyintensive treatment. J Pediatr Orthop 2000;20:642-7.
  • Aronson J, Puskarich CL. Deformity and disability from- treated clubfoot. J Pediatr Orthop 1990;10:109-119.
  • Dimeglio A, Bonnet F, Mazeau P, De Rosa V. Orthopae- dictreatment and passive motion machine: consequences for thesurgical treatment of clubfoot. J Pediatr Orthop B 1996;5:173-180.
  • Laaveg SJ, Ponseti IV. Long-term results of treatment of congenital club foot. J Bone Joint Surg [Am] 1980;62:23- 31.
  • Cooper DM, Dietz FR. Treatment of idiopathic clubfoot. A thirty-year follow-up note. J Bone Joint Surg [Am] 1995;77:1477-1489.
  • Ponseti IV. Treatment of congenital club foot. J Bone Joint Surg[Am] 1992;74:448-454.
  • Dimeglio A, Bensahel H, Souchet P, Mazeau P, Bonnet F. Classification of clubfoot. J Pediatr Orthop B 1995;4:129- 136.
  • Ippolito E, Farsetti P, Caterini R, Tudisco C. Long-term comparative results in patients with congenital clubfoot treated with two different protocols. J Bone Joint Surg Am 2003;85:1286-1294.
  • Catterall A. Early assessment and management of the club foot. In: Benson MK, Fixsen JA, Macnicol MF, Parsch K, editors. Childrenıs orthopaedics and fractures. 2nd ed. London; Churchill Livingstone 2002:464-477.
  • Pirani S, Zeznik L, Hodges D. Magnetic resonance imag- ing study of the congenital clubfoot treated with the Pon- seti method. J Pediatr Orthop 2001;21:719-726.
  • Kite JH. Nonoperative treatment of congenital clubfoot. Clin Orthop 1972;84:29-38.
  • Tümer Y, Biçimoğlu A, Açıkgöz T, Dinçer D. Doğuştan pes ekinovarus’un konservatif tedavisi. Acta Orthop Traumatol Turc 1982;16:148-159.
  • Bursalı A. Pes ekino varus (PEV) tedavisinde Ponseti me- todunun erken sonuçları. In: Alpaslan AM, editör. XVII. Ulusal Ortopedi ve Travmatoloji Kongresi Kongre Kitabı; 24-29 Ekim 2001; Turgut Yayıncılık; 2001:338-339.
  • Herzenberg JE, Radler C, Bor N. Ponseti versus traditional methods of casting for idiopathic clubfoot. J Pediatr Or- thop 2002;22:517-521.
  • Morcuende JA, Dolan LA, Dietz FR, Ponseti IV. Radical reduction in the rate of extensive corrective surgery for clubfoot 2004;113:376-380. method. Pediatrics
  • Dobbs MB, Rudzki JR; Purcell DB, et al. Factors predic- tive of outcome after use of the Ponseti method for the treatment ofidiopathic clubfeet. J Bone Joint Surg Am 2004;86:22-27.
  • Thacker MM, Scher DM, Sala DA, et al. Use of the foot abductionorthosis following Ponseti casts: is it essential? J Pediatr Orthop 2005;25:225-228.
  • Goksan SB. Treatment of congenital clubfoot with Ponseti method. Acta Orthop Traumatol Turc 2002;36:281-287.
  • Varol T, Karakurt L, Belhan O, Tosun BH. Doğustan çar- pık ayaklı olgularda Ponseti Yöntemi ile tedavi sonuçlarımız. Fırat Tıp Dergisi 2008;13:116-119.
There are 26 citations in total.

Details

Primary Language Turkish
Journal Section Research Article
Authors

İbrahim Azboy This is me

Güzelali Özdemir This is me

Sinan Zehir This is me

Ahmet Şükrü Mercan This is me

Abdullah Demirtaş This is me

Publication Date March 1, 2011
Published in Issue Year 2011

Cite

APA Azboy, İ., Özdemir, G., Zehir, S., Mercan, A. Ş., et al. (2011). Doğuştan çarpık ayaklı olgularda Ponseti yöntemi ile tedavi sonuçları. Journal of Clinical and Experimental Investigations, 2(1), 30-34. https://doi.org/10.5799/ahinjs.01.2011.01.0206
AMA Azboy İ, Özdemir G, Zehir S, Mercan AŞ, Demirtaş A. Doğuştan çarpık ayaklı olgularda Ponseti yöntemi ile tedavi sonuçları. J Clin Exp Invest. March 2011;2(1):30-34. doi:10.5799/ahinjs.01.2011.01.0206
Chicago Azboy, İbrahim, Güzelali Özdemir, Sinan Zehir, Ahmet Şükrü Mercan, and Abdullah Demirtaş. “Doğuştan çarpık Ayaklı Olgularda Ponseti yöntemi Ile Tedavi sonuçları”. Journal of Clinical and Experimental Investigations 2, no. 1 (March 2011): 30-34. https://doi.org/10.5799/ahinjs.01.2011.01.0206.
EndNote Azboy İ, Özdemir G, Zehir S, Mercan AŞ, Demirtaş A (March 1, 2011) Doğuştan çarpık ayaklı olgularda Ponseti yöntemi ile tedavi sonuçları. Journal of Clinical and Experimental Investigations 2 1 30–34.
IEEE İ. Azboy, G. Özdemir, S. Zehir, A. Ş. Mercan, and A. Demirtaş, “Doğuştan çarpık ayaklı olgularda Ponseti yöntemi ile tedavi sonuçları”, J Clin Exp Invest, vol. 2, no. 1, pp. 30–34, 2011, doi: 10.5799/ahinjs.01.2011.01.0206.
ISNAD Azboy, İbrahim et al. “Doğuştan çarpık Ayaklı Olgularda Ponseti yöntemi Ile Tedavi sonuçları”. Journal of Clinical and Experimental Investigations 2/1 (March 2011), 30-34. https://doi.org/10.5799/ahinjs.01.2011.01.0206.
JAMA Azboy İ, Özdemir G, Zehir S, Mercan AŞ, Demirtaş A. Doğuştan çarpık ayaklı olgularda Ponseti yöntemi ile tedavi sonuçları. J Clin Exp Invest. 2011;2:30–34.
MLA Azboy, İbrahim et al. “Doğuştan çarpık Ayaklı Olgularda Ponseti yöntemi Ile Tedavi sonuçları”. Journal of Clinical and Experimental Investigations, vol. 2, no. 1, 2011, pp. 30-34, doi:10.5799/ahinjs.01.2011.01.0206.
Vancouver Azboy İ, Özdemir G, Zehir S, Mercan AŞ, Demirtaş A. Doğuştan çarpık ayaklı olgularda Ponseti yöntemi ile tedavi sonuçları. J Clin Exp Invest. 2011;2(1):30-4.