Comparison of the Soft-Tissue Release Methods in Idiopathic Clubfoot

Centel, Tuncay; Bagatur, A. Erdem; Öğüt, Tahir; Aksu, Taner

doi:10.1097/00004694-200009000-00019

Cited by 8 publications

(3 citation statements)

References 16 publications

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“…As in previous studies [3,5,17], our study found that residual stiffness and deformity translated into functional limitations and pain in the operative group. In both pain and global functioning in the PODCI survey, the operative group had a significantly lower score (poorer outcome) than the Ponseti group.…”

Section: Discussionsupporting

confidence: 84%

“…Surgical treatment can be placed into two groups: 'a la carte' and extensive posteromedial release (PMR) [2] in its many variants. Surgical treatment provides a high percentage of short-term, clinically satisfactory radiological results [3]; however, long-term follow-up results, based on examinations, questionnaires, radiographic analyses [4,5], and kinematics [6], are disappointing. Currently, most physicians agree that extensive soft-tissue release surgeries (joint invasive) should be avoided and that a more conservative, joint-sparing approach should be considered first [5,[7][8][9][10][11][12][13].…”

Section: Introductionmentioning

confidence: 99%

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A comprehensive outcome comparison of surgical and Ponseti clubfoot treatments with reference to pediatric norms

Church

Coplan

Poljak

et al. 2012

Journal of Children's Orthopaedics

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Purpose Isolated congenital clubfoot can be treated either operatively (posteromedial release) or conservatively (Ponseti method). This study retrospectively compared mid-term outcomes after surgical and Ponseti treatments to a normal sample and used multiple evaluation techniques, such as detailed gait analysis and foot kinematics. Methods Twenty-six children with clubfoot treated surgically and 22 children with clubfoot treated with the Ponseti technique were evaluated retrospectively and compared to 34 children with normal feet. Comprehensive evaluation included a full gait analysis with multi-segment and single-segment foot kinematics, pedobarograph, physical examination, validated outcome questionnaires, and radiographic measurements. Results The Ponseti group had significantly better plantarflexion and dorsiflexion range of motion during gait and had greater push-off power. Residual varus was present in both treatment groups, but more so in the operative group. Gait analysis also showed that the operative group had residual in-toeing, which appeared well corrected in the Ponseti group. Pedobarograph results showed that the operative group had significantly increased varus and significantly decreased medial foot pressure. The physical examination demonstrated significantly greater stiffness in the operative group in dorsiflexion, plantarflexion, ankle inversion, and midfoot abduction and adduction. Surveys showed that the Ponseti group had significantly more normal pediatric outcome data collection instrument results, disease-specific indices, and Dimeglio scores. The radiographic results suggested greater equinus and cavus and increased foot internal rotation profile in the operative group compared with the Ponseti group.

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Section: Discussionsupporting

confidence: 84%

Section: Introductionmentioning

confidence: 99%

A comprehensive outcome comparison of surgical and Ponseti clubfoot treatments with reference to pediatric norms

Church

Coplan

Poljak

et al. 2012

Journal of Children's Orthopaedics

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“…In the past, surgical treatment was the preferred method, and has been found to achieve good or satisfactory short-term results. 4 , 5 In most cases, surgery is preceded by various forms of conservative therapy involving different massage, stretching, manipulation and immobilization techniques to correct the deformities. If different manipulation protocols do not completely correct the deformities, surgical interventions in the form of posteromedial release (PMR) or complete subtalar release are often necessary.…”

Section: Introductionmentioning

confidence: 99%

<p>Posteromedial Release versus Ponseti Treatment of Congenital Idiopathic Clubfoot: A Long-Term Retrospective Follow-Up Study into Adolescence</p>

Corbu¹,

Cosma²,

Vasilescu³

et al. 2020

TCRM

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Purpose Although many short-term studies have shown the superiority of Ponseti treatment to surgical treatment, studies with long-term follow-up of patients into adolescence are lacking. The aim of this study was to compare the morphological, functional and radiological results of the two methods into and during adolescent age, when both soft tissue and bony procedures can be performed to correct residual deformities. Patients and Methods We retrospectively evaluated two groups of patients diagnosed with congenital idiopathic clubfoot and treated with either the Ponseti method (34 clubfeet) and surgery in the form of posteromedial release (31 clubfeet). All included clubfeet were clinically fully corrected after initial treatment and final plaster removal. Evaluation was performed with the International Clubfoot Study Group (ICFSG) score. Results The age at follow-up was 12.8±1.6 years in the Ponseti group and 13.5±1.7 years in the surgical group. Excellent or good results were obtained in 26 feet (76%) of the Ponseti group and in 14 feet (45%) in the surgical group. The Ponseti treatment was significantly superior to posteromedial release in terms of the final score (10.58±6.49 versus 17.26±8.83, p<0.001), functional score (p<0.001) and radiological score (p<0.001). Residual deformities were clinically present in both groups but were less frequent and less severe in Ponseti-treated patients. Flat-top talus was found to be present in both groups, but the Ponseti method was more protective than surgical treatment against this outcome (relative risk=0.494, p=0.002). The overall foot and ankle mobility was significantly better in the Ponseti group (p<0.001). Conclusion The Ponseti method was superior to surgery for treatment of clubfoot and achieved better long-term morphological, functional and radiological results. It preserves better mobility of the foot and ankle, and results in less frequent and less severe residual deformities than surgical treatment.

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Comparative results of percutaneous Achilles tenotomy to combined open Achilles tenotomy with posterior capsulotomy in the correction of equinus deformity in congenital talipes equinovarus

Grigoriou

Oyoun

Kushare

et al. 2015

International Orthopaedics (SICOT)

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In our series, the addition of posterior capsulotomy to Achilles tenotomy did not improve the mean dorsiflexion at latest follow up or decrease the rate of recurrence of equinus deformity in both idiopathic and non-idiopathic clubfeet. It is therefore advisable that percutaneous Achilles tenotomy alone be used in the correction of equinus deformity in both idiopathic and non-idiopathic congenital talipes equinovarus after successful Ponseti serial casting.

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Comparison of the Soft-Tissue Release Methods in Idiopathic Clubfoot

Cited by 8 publications

References 16 publications

A comprehensive outcome comparison of surgical and Ponseti clubfoot treatments with reference to pediatric norms

A comprehensive outcome comparison of surgical and Ponseti clubfoot treatments with reference to pediatric norms

<p>Posteromedial Release versus Ponseti Treatment of Congenital Idiopathic Clubfoot: A Long-Term Retrospective Follow-Up Study into Adolescence</p>

Comparative results of percutaneous Achilles tenotomy to combined open Achilles tenotomy with posterior capsulotomy in the correction of equinus deformity in congenital talipes equinovarus

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