Functional treatment of clubfoot: a new series of 350 idiopathic clubfeet with long-term follow-up

Souchet, Philippe; Bensahel, H; Thémar-Noël, Christine; Penneçot, Georges-François; Csukonyi, Z

doi:10.1097/01202412-200405000-00009

Cited by 20 publications

(27 citation statements)

References 15 publications

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“…A series of studies of long term follow up of conservatively managed clubfoot deformities using the "functional method" as described by Bensahel et al (8) has shown increasingly good results using this nonoperative method, despite the severity of the deformity. This was confirmed by a larger study by Souchet et al (9), in which 350 cases were followed up for mean of 14 years.…”

Section: Discussionsupporting

confidence: 69%

Surgical Treatment of Idiopathic Clubfoot

2016

IJSR

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Section: Discussionsupporting

confidence: 69%

Surgical Treatment of Idiopathic Clubfoot

2016

IJSR

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“…Subjecting all clubfoot patients to routine screening with imaging, however, is impractical and unnecessary. In the functional treatment method of clubfoot [13], the accessory soleus muscle, if present, may cause persistence of hindfoot deformity after limited surgery, and requires a release at its insertion.…”

Section: Discussionmentioning

confidence: 99%

“…The relevance of awareness about the accessory soleus muscle is more pertinent, particularly with conservative methods of clubfoot management requiring additional minimal surgery, like the Ponseti [12] method and the physical functional treatment method [13], gaining popularity. Persistence of hindfoot deformity even after tendoachilles tenotomy as described by Ponseti [12] may be an indicator of the presence of this anomalous muscle.…”

Section: Discussionmentioning

confidence: 99%

Accessory soleus muscle in clubfoot deformity: a report in four feet

Gupta

Singla²,

Gupta

et al. 2007

Journal of Pediatric Orthopaedics B

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The commonest presentation of accessory soleus muscle is a swelling at the posteromedial aspect of the ankle in adolescents or young adults. Accessory soleus is rarely encountered in children undergoing surgical release for congenital clubfoot, and only a few isolated reports are available in the literature. The purpose of this study is to heighten awareness about the role of accessory soleus muscle in clubfoot deformity. Four cases of accessory soleus muscle in patients undergoing surgical release for clubfoot deformity are reported here in which, a distinct anomalous muscle deep to the tendoachilles was identified. Hindfoot varus and equinus persisted in each of these cases despite an adequate posteromedial soft tissue release, which could be corrected only on tenotomizing the tendon of the accessory soleus muscle at its insertion. An awareness about the accessory soleus muscle is important, particularly when non-operative methods of clubfoot management with tendoachilles tenotomy or limited surgery are employed. Failure to recognize this muscle if present in patients with congenital clubfoot may lead to persistent hindfoot deformity. A high index of suspicion should be maintained in cases in which hindfoot deformity persists despite an otherwise adequate soft tissue correction.

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“…Henri Bensahel et al [29] from Paris was using physical therapy and taping as his initial treatment for clubfeet. For a clubfoot-requiring surgery Bensahel described an à la carte approachyyyyy'do only what is necessary to give a good correction of the foot' [30].…”

Section: The Surgical Schoolmentioning

confidence: 99%

Clubfoot in the twentieth century

Carroll¹

2012

Journal of Pediatric Orthopaedics B

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In the twentieth century clubfoot was one of the commonest congenital deformities of the musculoskeletal system with an incidence in some races as low as 0.6 and in others as high as 6.8 per thousand live births (Polynesia). Males have the deformity twice as often as females. In the early 1900s forceful correction of the deformity as espoused by Hugh Owen Thomas was in vogue. In the 1930s Joseph Hiram Kite, like Hippocrates (400 BC), recommended repeated gentle manipulations to achieve a correction. Instead of bandages Kite used serial plaster casts to maintain the correction. During the late 1940s Ignatio Ponseti developed his technique of correction through the normal arc of the subtalar joint. In a clubfoot the soft tissues are more resistant to pressure than the bones. With this concept in mind soft tissue procedures were developed in which the capsules and ligaments were released surgically. With safer pediatric anesthesia the 1960s, 1970s, and 1980s saw surgical approaches that were more and more aggressive even including a complete subtalar release. The improved imaging modalities and computer graphics of the 1980s led to a better understanding of the pathoanatomy. Long-term follow-up studies demonstrating malcorrection, overcorrection, pain, and stiffness dampened the enthusiasm for very aggressive surgery. The main problem with surgery is that clubfoot wounds heal by a patching up process called repair. The losses are made good not with the original tissue but with a material that is biologically simple, cheap, and handy - connective tissue scar! As the century drew to a close there was a major swing of the pendulum to the Ponseti method. Surgeons are now learning the limitations of this method. Finally, the author tries to imagine what may happen in the future prevention, classification, and treatment of clubfoot with all the advances in cell biology, molecular biology, biomechanics, biomaterials, surgery, orthotics, and evidence-based medicine.

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Functional treatment of clubfoot: a new series of 350 idiopathic clubfeet with long-term follow-up

Cited by 20 publications

References 15 publications

Surgical Treatment of Idiopathic Clubfoot

Surgical Treatment of Idiopathic Clubfoot

Accessory soleus muscle in clubfoot deformity: a report in four feet

Clubfoot in the twentieth century

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