Clubfoot relapse: Does presentation differ based on age at initial relapse?

Mahan, Susan T.; Spencer, Samantha A.; May, Collin; Prete, V I; Kasser, James R.

doi:10.1302/1863-2548.11.170016

Cited by 21 publications

(20 citation statements)

References 21 publications

(56 reference statements)

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“…Grade IIA that is Fixedequinus (41%) and bhaskar et al had (11%). Grade IIA in our study (41%) and bhaskar et al [11] . Grade IIB fixed adduction deformity in our study (21%) & bhaskar et al (11%) & Grade III mixed deformity in our study (7%) andbhaskar had (5%).…”

Section: Methodssupporting

confidence: 58%

The relapse pattern in clubfoot treated by ponseti method and there treatment modalities

Verma¹,

Gaur²,

Sharma³

et al. 2020

Int. J. Orthop. Sci.

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Background: Congenital talipes equino varus is the most common congenital foot disorder. Relapse of clubfoot deformity occurs after the treatment by ponseti method. We evaluate the relapse pattern of clubfoot basis of bhasker et al. then treat the patient by ponseti technique. Methods: This is a Retrospective and Prospective study. We are conducting a clubfoot clinic since 2013 in Department of Orthopaedics Gandhi medical college Bhopal. We register all clubfoot patient at our clubfoot clinic on his/her first visit. All the clubfeet assessed with pirani scoring system on the initial presentation to our institution and treat by ponseti method. During this study there were a total of 558 children with 713 idiopathic clubfeet registered at our clinic. A total of 49 idiopathic clubfeet in 34 children presenting with relapse were included in our study. Results: We found that The incidence of relapse feet in our study is 6.87% (49 feet out of 713 feet The total involvement of relapse feet on the basis of laterality, the unilateral 403 feet out of 713 feet and relapse is 19 feet (4.71%) and bilateral involved feet 310 out of 713 & there relapse is 30 feet (9.68%). The incidence of relapse feet more on bilateral feet involvement. The post treatment pirani score after relapse treatment is 0. Conclusion: Ponseti technique is a simple, effective, inexpensive method for treatment of clubfeet there is, no requirement of special setup with limited resources and less rate of recurrence/complication than the surgical treatment It has been concluded that Ponseti method is a effective technique to treat congenital idiopathic clubfeet with success rate is 91% in our study.

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Section: Methodssupporting

confidence: 58%

The relapse pattern in clubfoot treated by ponseti method and there treatment modalities

Verma¹,

Gaur²,

Sharma³

et al. 2020

Int. J. Orthop. Sci.

View full text Add to dashboard Cite

show abstract

“…Next, we assumed that more severe initial deformities underlie higher congenital deforming forces and are asso- (Avilucea et al 2009), (Dinesh et al 2017), (Chong et al 2014), (Haft et al 2007), (Limpaphayom and Sailohit 2019), (Mahan et al 2017), (Cosma et al 2018), (Mootha et al 2011), (Morcuende et al 2004), (Morcuende et al 2005), (Gelfer et al 2014), (Panjavi et al 2012), (Ramírez et al 2011), (Sangiorgio et al 2016), (Kang and Park 2015), (Sangiorgio et al 2017), (Zhao et al 2018) (Kuzma et al 2019), (Little et al 2019), (Vo and Huynh 2016) ciated with a higher recurrence risk. However, our analysis revealed inconclusive findings.…”

Section: Discussionmentioning

confidence: 99%

Prognostic factors for recurrent idiopathic clubfoot deformity: a systematic literature review and meta-analysis

et al. 2021

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Background and purpose After initial clubfoot correction through Ponseti treatment, recurrence rates range from 26% to 48%. Even though various factors have been associated with increased recurrence risk, systematic assessments of the prognostic capacity of recurrence risk factors and their clinical relevance are lacking. Therefore we assessed clinically relevant prognostic factors for recurrent idiopathic clubfoot deformity after initial correction through Ponseti treatment. Methods PubMed, Embase, Cinahl, and Web of Science were systematically searched for studies investigating the association between clinically relevant factors and recurrence rates. Prognostic factors were qualitatively assessed and included in the meta-analysis if ≥ 2 studies investigated the same factor and methods were comparable. Results 34 articles were included in the qualitative synthesis, of which 22 were also included in the meta-analysis. Meta-analysis revealed that poor evertor muscle activity (OR = 255, 95% CI 30–2,190), brace non-compliance (OR = 10, CI 5–21), no additional stretching (OR = 31, CI 10–101), more casts (OR = 3.5, CI 1.6–7.8), lower education level of parents (OR = 1.8, CI 1.2–2.6), non-marital status of parents (OR = 1.8, CI 1.1–3.0), and higher Dimeglio scores (OR = 1.9, CI 1.2–3.3) were associated with higher recurrence rates. Interpretation Brace non-compliance and poor evertor muscle activity have been identified as main recurrence risk factors and are therefore important to be closely monitored during clinical follow-up of clubfoot patients. Adding additional stretching during the bracing protocol might be promising in the quest to prevent relapse, but scientific evidence for clear clinical treatment recommendations is still limited.

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“…Early relapse is usually encountered within the first 2 years of successfully completing the Ponseti treatment [8][9][10][11][12] and responds relatively well to the repeated application of this method [9,10,13,14]. Late relapsed feet are frequently treated with various types of surgery; however, the Ponseti technique is still recommended as the first treatment irrespective of age or severity of the deformity.…”

Section: Introductionmentioning

confidence: 99%

Concomitant Talocalcaneal Coalition as a Risk Factor for Early Relapse Following Ponseti Treatment of Idiopathic Clubfoot

et al. 2021

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Concomitant talocalcaneal coalition (TCC) in idiopathic clubfeet is not well documented in the literature. The purpose of this study was to describe our experience with very early relapsing idiopathic clubfeet associated with TCC. Although cases have been successfully treated with the Ponseti casting method, all recurred within 2 months of removing the final cast. A single-centre cohort of twelve feet in eight patients treated by a single surgeon between 2006 and 2020 was investigated retrospectively. Recurred cavus with variable degrees of equinus was the earliest findings noted. TCC was incidentally detected during the open reduction of the earliest three feet in our series. Afterwards, ultrasonography was advised as a screening tool for detecting an associated anomaly; however, only the use of magnetic resonance imaging (MRI) was 100% accurate in diagnosing concurrent TCC. All coalitions were cartilaginous and the posterior facet was most commonly involved facet. The average age was 18 months for the coalition resection and open reduction of a dislocated talonavicular joint, and the average duration of follow-up was 52 months. None of the patients showed clinical signs of relapse at the latest follow-up. We recommend that an associated TCC should be considered in very early relapsing idiopathic clubfoot cases.

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Clubfoot relapse: Does presentation differ based on age at initial relapse?

Cited by 21 publications

References 21 publications

The relapse pattern in clubfoot treated by ponseti method and there treatment modalities

The relapse pattern in clubfoot treated by ponseti method and there treatment modalities

Prognostic factors for recurrent idiopathic clubfoot deformity: a systematic literature review and meta-analysis

Concomitant Talocalcaneal Coalition as a Risk Factor for Early Relapse Following Ponseti Treatment of Idiopathic Clubfoot

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