Clinical and functional outcome of relapse surgery in severe congenital talipes equinovarus

Harvey, Adrian R.; Uglow, M. G.; Clarke, Nicholas

doi:10.1097/01202412-200301000-00009

Cited by 6 publications

(8 citation statements)

References 19 publications

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“…The average age of our patients was 15.5 months, which is comparable with that of other studies [19][20][21][22]. Most of the patients were male, and the male-to-female ratio was 1.9.…”

Section: Discussionsupporting

confidence: 83%

Clinical outcome of posteromedial versus posteromedial-lateral release for clubfoot

Hallaj-Moghadam

Moradi

Ebrahimzadeh

2015

Journal of Pediatric Orthopaedics B

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“…The average age of our patients was 15.5 months, which is comparable with that of other studies [19][20][21][22]. Most of the patients were male, and the male-to-female ratio was 1.9.…”

Section: Discussionsupporting

confidence: 83%

Clinical outcome of posteromedial versus posteromedial-lateral release for clubfoot

Hallaj-Moghadam

Moradi

Ebrahimzadeh

2015

Journal of Pediatric Orthopaedics B

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“…However, our results concur with previous reports in that surgery for relapsed clubfoot gives a high percentage of unsatisfactory results. 19,32 Unlike other authors', 12 we found no significant correlation between passive ankle dorsiflexion and outcome.…”

Section: Discussioncontrasting

confidence: 72%

“…16 In the younger child soft-tissue release may be sufficient to achieve correction which has not been provided by primary treatment, 16,20 whereas bony operations, variously combined with soft-tissue procedures, are required in the older child. 19 Tendon transfers play a secondary role and are indicated when muscle imbalance is a deforming or aggravating factor. 2,16,[23][24][25][26][27] Such imbalance may occur with a range of presentations.…”

Section: Discussionmentioning

confidence: 99%

“…8,9,15,20 As different deformities may be present, a comprehensive surgical approach is required, tailored to the deformity 2,6,21,22 and the age of the child. 19 Surgical techniques for relapsed congenital clubfeet can be divided into three broad categories namely soft-tissue releases, bony procedures and tendon transfers, the former two representing the main corrective procedures. 16 In the younger child soft-tissue release may be sufficient to achieve correction which has not been provided by primary treatment, 16,20 whereas bony operations, variously combined with soft-tissue procedures, are required in the older child.…”

Section: Discussionmentioning

confidence: 99%

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Transfer of the tendon of tibialis anterior in relapsed congenital clubfoot

Lampasi

Bettuzzi

Palmonari

et al. 2010

The Journal of Bone and Joint Surgery. British volume

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A total of 38 relapsed congenital clubfeet (16 stiff, 22 partially correctable) underwent revision of soft-tissue surgery, with or without a bony procedure, and transfer of the tendon of tibialis anterior at a mean age of 4.8 years (2.0 to 10.1). The tendon was transferred to the third cuneiform in five cases, to the base of the third metatarsal in ten and to the base of the fourth in 23. The patients were reviewed at a mean follow-up of 24.8 years (10.8 to 35.6). A total of 11 feet were regarded as failures (one a tendon failure, five with a subtalar fusion due to over-correction, and five with a triple arthrodesis due to under-correction or relapse). In the remaining feet the clinical outcome was excellent or good in 20 and fair or poor in seven. The mean Laaveg-Ponseti score was 81.6 of 100 points (52 to 92). Stiffness was mild in four feet and moderate or severe in 23. Comparison between the post-operative and follow-up radiographs showed statistically significant variations of the talo-first metatarsal angle towards abduction. Variations of the talocalcaneal angles and of the overlap ratio were not significant. Extensive surgery for relapsed clubfoot has a high rate of poor long-term results. The addition of transfer of the tendon of tibialis anterior can restore balance and may provide some improvement of forefoot adduction. However, it has a considerable complication rate, including failure of transfer, over-correction, and weakening of dorsiflexion. The procedure should be reserved for those limited cases in which muscle imbalance is a causative or contributing factor.

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“…These options vary from extensive soft-tissue releases to osteotomies and fusions, external fixation, and even triple arthrodesis. [9][10][11][12][13][14][15][16][17][18] This report focuses on idiopathic clubfeet, initially well corrected, that were treated after 4 years of age for their relapsing deformities. We report the presenting characteristics of these patients' feet and the results applying the Ponseti method principles.…”

mentioning

confidence: 99%

Treatment Results of Late-relapsing Idiopathic Clubfoot Previously Treated With the Ponseti Method

McKay

Dolan

Morcuende

2012

Journal of Pediatric Orthopaedics

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Clinical and functional outcome of relapse surgery in severe congenital talipes equinovarus

Cited by 6 publications

References 19 publications

Clinical outcome of posteromedial versus posteromedial-lateral release for clubfoot

Clinical outcome of posteromedial versus posteromedial-lateral release for clubfoot

Transfer of the tendon of tibialis anterior in relapsed congenital clubfoot

Treatment Results of Late-relapsing Idiopathic Clubfoot Previously Treated With the Ponseti Method

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