In the last decade, the Ponseti method has been recognized by most orthopedists around the world as the gold standard for clubfoot treatment. However, the efficiency of the Ponseti method in relapsing forms of congenital clubfoot in children has been under-examined. We analyzed 103 patients with relapsing clubfoot, aged 1 to 9 years, who were treated at the National Center of Rehabilitation and Prosthetics of the Disabled from 2017 to 2019. These patients had a relapse with typical clubfoot contractures without multiplanar deformity of the feet. The treatment process consisted in the application of the method of I. Ponseti for all patients; if indicated, transplantation of the tendon of the anterior tibial muscle was performed.

Vitamin D affects estrogen level by stimulating the synthesis of testosterone, estrogen and progesterone. Insufficiency of vitamin D leads to a decrease in the values of these steroid hormones. The average value of 25 (OH) D was 26.95 ± 16.6 ng/ml, which indicates insufficiency. The median estradiol was 47.85 pg/ml, which is below the reference values during the follicular phase. Vitamin D deficiency in this sample may be one of the reasons. Prophylactic vitamin D and calcium supplementation will contribute to the improvement of this situation.

This study shows that a combined treatment regimen consisting of a NSAID group drug and a slow-acting chondroprotective agent has a positive effect in the therapy of subcompensated osteoarthritis of the knee joint. Diacerein has an anti-inflammatory effect and inhibits the activity of interleukin-1, interleukin-6, and TNF-alpha, as well as collagenase and elastase, which destroy the hyaline cartilage. However, the effect of the drug does not occur immediately, which justifies its combination with NSAIDs.

Hallux valgus is characterized by the appearance and growth of a painful “lump” in the region of the first metatarsophalangeal joint, the development of forefoot corns, and inability to choose the right shoes, which leads to a significant decrease in the quality of life of these patients. Corrective osteotomies that preserve the metatarsophalangeal joint, for example Austin (Chevron) osteotomy, are usually used for hallux valgus deformity of the I, II degrees. Radiography with the study of the hallux valgus angle (HVA), the intermetatarsal angle (IMA), the distal metatarsal articular angle (DMAA) is a research method that shows the true correlation between bone structures. The correlation between the radiological and functional indicators of osteotomy allows us to determine possible recommendations for indications for surgical treatment of Hallux valgus. Correlation shows that the largest correction of hallux valgus in older patients occurs due to a small adjustment of the angle of DMMA and HVA. IMA had the best correction after Austin osteotomy among patients of a younger age, then the HVA, and the DMMA had minimum correction according to the AOFAS rating scale (Kitaoka). The revealed correlations allow us to determine the correct tactics for the treatment of hallux valgus by identifying the benefits of Austin osteotomy.