Clinical outcome of posteromedial versus posteromedial-lateral release for clubfoot

Hallaj-Moghadam, Mohammad; Moradi, Ali; Ebrahimzadeh, Mohammad Ali

doi:10.1097/bpb.0000000000000124

Cited by 10 publications

(7 citation statements)

References 30 publications

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“…Currently, most authors suggest conservative treatment for clubfoot, restricting the indication for surgery in cases of recurrent or resistant deformity [ 23 – 28 ]. In newborns, conservative treatment with the Ponseti method is effective in most cases with a high rate of good results [ 29 ].…”

Section: Discussionmentioning

confidence: 99%

Congenital idiopathic talipes equinovarus before and after walking age: observations and strategy of treatment from a series of 88 cases

Faldini

Traina

Nanni

et al. 2015

J Orthopaed Traumatol

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BackgroundWe reviewed a series of newborns, toddlers and ambulating children affected by idiopathic congenital talipes equinovarus (clubfoot). Taking into account the time of diagnosis, stiffness of the deformity and walking age, nonsurgical or surgical treatment was considered. This study reports clinical outcomes, early complications and relapse at mid-term follow-up.Materials and methodsFifty-two clubfeet were diagnosed at birth, 12 in non-ambulating children aged between 4 and 12 months and 24 in ambulating children. Feet were classified using the Pirani score. Newborns and toddlers were treated with serial casting (Ponseti); however, toddlers also underwent open Achilles tendon lengthening (2 feet) and posteromedial release (3 feet). In all ambulating children, surgical treatment was always performed: selective medial release combined with cuboid subtraction osteotomy (1 foot), posteromedial release (6 feet), and posteromedial release combined with cuboid subtraction osteotomy (17 feet).ResultsThe average follow-up was 5 years (1–6 years). In newborns treated with Ponseti, the results were excellent in 42 feet, good in 6, and poor in 4. In non-ambulating children, the results were excellent in 9 feet, and good in 3. In ambulating children, the results were excellent in 5 feet, good in 16, and poor in 3. No major complications were reported. No overcorrections were observed. The need for open surgery was higher in cases of delayed treatment. In cases of relapse, re-casting and/or more extensive surgery was considered.ConclusionsEarly treatment enables a high rate of good correction to be obtained with serial casting and limited surgery. Conversely, if the deformity is observed after walking age surgery should be considered. Serial casting in cases of late observation and relapse have demonstrated encouraging results.Level of evidenceIV.

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Section: Discussionmentioning

confidence: 99%

Congenital idiopathic talipes equinovarus before and after walking age: observations and strategy of treatment from a series of 88 cases

Faldini

Traina

Nanni

et al. 2015

J Orthopaed Traumatol

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“…Congenital clubfoot is a common deformity of children, which consists of equinus, hindfoot varus, forefoot adductus and cavus [ 1 ]. The etiology of Congenital Clubfoot is largely unknown [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Factors associated with the relapse in Ponseti treated congenital clubfoot

Hu¹,

Ke²,

Niansu³

et al. 2022

BMC Musculoskelet Disord

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Objectives We retrospectively investigated the clinical materials to seek the factors that lead to relapse after using the Ponseti method. Methods We retrospectively reviewed all children with congenital clubfoot treated with the Ponseti method in our hospital from June 2008 to June 2013. The data included the following factors: age, gender, initial Pinari score, number of casts, number of feet (unilateral or bilateral), age at the first casting, age of mother, tenotomy, walking age, and compliance with using bracing. All investigations were conducted in conformity with ethical standards. This study was approved by Guilin Peoples’ Hospital Ethics Committee. Results In this study, there were 148 cases (164 ft) in total that underwent the Ponseti method, with the follow–up period at least 5 years. Of them, 64 children presented with left side, 58 with right side, and 26 with bilateral cases. This study included 75 males and 73 females; sex did not affect the outcomes. The mean age of the first casting was 2.50 ± 2.15 months. The average initial Pirani score was 4.98 ± 1.33, and the average number of casts was 5.71 ± 2.28 times. The mean age of mothers at birth was 25.81 ± 2.38 years old. The walking age of children was at a mean of 14.83 ± 1.18 months. Forty-nine cases could not tolerate using braces, namely the rate of noncompliance in this study was 33.1%. Tenotomy was performed on 113 ft (76.4%). The average follow–up period was 7.27 ± 1.29 years (from 5 to 10 years). The rate of relapse was 21.6% (32 cases) at the end of the follow-up. The rate of relapse in the noncompliance with using bracing group was significantly higher compared to the compliance group . Conclusion The initial Pirani score, compliance with the foot abduction brace and the age at the first casting are three independent factors for relapse in clubfoot.

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“…Idiopathic clubfoot is defined as isolated deformity of one or both limbs, which consists of four components: equines, hind foot varus, forefoot adductus, and cavus [ 1 , 2 ]. Although clubfoot is one of the most known congenital deformities that occurs in one per 1000 live births [ 3 ], its management, especially in severe cases, is still challenging.…”

Section: Introductionmentioning

confidence: 99%

Ponseti Casting for Severe Club Foot Deformity: Are Clinical Outcomes Promising?

Hallaj-Moghaddam

Moradi

Ebrahimzadeh

et al. 2015

Advances in Orthopedics

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Between 2007 and 2010, a prospective study was done on 85 patients with severe idiopathic nonsyndromic clubfeet, in our center. Demographic features, severity of the deformity before and after serial casting according to Diméglio classification, and complications were assessed. The mean age of the patients was 8 days and 69% were male. The mean follow-up period was 26 months. The average number of castings used to correct the deformity was 5.7 times (range: 4 to 8). Tenotomy was performed in 76 (89.4%) of the feet. In all patients, plantigrade foot was achieved. Tenotomy occurred more in patients with higher Diméglio scores. Although patients who underwent Achilles tenotomy began to walk later than those who did not (13 ± 7.2 versus 9.2 ± 18), it was not significant (P = 0.06). Relapse rate, at the end of follow-up, was 27.1%. Diméglio score before casting was 16 ± 3.4 and at the end of follow-up it was 1.6 ± 6.2. The patients with bilateral clubfeet had inferior final outcome compared to those with unilateral clubfoot. Eighty percent of parents' were completely satisfied with their child's gait and foot appearance (94.1%). Ponseti method of manipulation and casting is a valuable technique in severe club foot as well as in common types.

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Clinical outcome of posteromedial versus posteromedial-lateral release for clubfoot

Abstract: Level III, therapeutic study.

Cited by 10 publications

References 30 publications

Congenital idiopathic talipes equinovarus before and after walking age: observations and strategy of treatment from a series of 88 cases

Congenital idiopathic talipes equinovarus before and after walking age: observations and strategy of treatment from a series of 88 cases

Factors associated with the relapse in Ponseti treated congenital clubfoot

Ponseti Casting for Severe Club Foot Deformity: Are Clinical Outcomes Promising?

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