Long-Term Follow-up of Patients with Clubfeet Treated with Extensive Soft-Tissue Release

Dobbs, Matthew B.; Nunley, Ryan M.; Schoenecker, Perry L.

doi:10.2106/jbjs.e.00114

Cited by 221 publications

(216 citation statements)

References 63 publications

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“…A parent must often be used as a proxy [28]. Dobbs et al [10] used the SF-36 questionnaire [24]. We used the previously validated Roye et al [28] DSI to measure satisfaction outcomes.…”

Section: Discussionmentioning

confidence: 99%

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Ponseti Treatment for Idiopathic Clubfoot: Minimum 5-year Followup

Bor

Coplan

Herzenberg

2009

Clinical Orthopaedics &Amp; Related Research

141

117

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Ponseti clubfoot treatment has become more popular during the last decade. We reviewed the medical records of 74 consecutive infants (117 club feet) who underwent Ponseti treatment. Minimum followup was 5 years (mean, 6.3 years; range, 5-9 years). We studied age at presentation, previous treatment, the initial severity score of the Pirani scoring system, number of casts, need for Achilles tenotomy or other surgical procedures, and brace use. We measured final ankle motion and parents' perception of outcome. Late presentation and previous nonPonseti treatment were associated with lower initial severity score, fewer casts, and less need for tenotomy.

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“…A parent must often be used as a proxy [28]. Dobbs et al [10] used the SF-36 questionnaire [24]. We used the previously validated Roye et al [28] DSI to measure satisfaction outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…Patients who eventually require extensive open surgical release might have poor outcomes [10]. During the last decade, there has been renewed interest in the Ponseti method of clubfoot treatment.…”

Section: Introductionmentioning

confidence: 99%

Ponseti Treatment for Idiopathic Clubfoot: Minimum 5-year Followup

Bor

Coplan

Herzenberg

2009

Clinical Orthopaedics &Amp; Related Research

141

117

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“…Recently, with the perception that extensive soft tissue releases are often complicated by stiffness and residual or recurrent deformities at long-term followup, there has been considerable interest in the minimally invasive Ponseti method. Dobbs et al [5] reported poor results in nearly 50% of patients treated by an extensive soft tissue release at 25 years followup, mainly as a result of stiffness. An average of 2.3 surgeries was performed per patient, and nearly all had a weakness in pushoff [5].…”

Section: Discussionmentioning

confidence: 99%

“…Dobbs et al [5] reported poor results in nearly 50% of patients treated by an extensive soft tissue release at 25 years followup, mainly as a result of stiffness. An average of 2.3 surgeries was performed per patient, and nearly all had a weakness in pushoff [5]. The Ponseti method has dramatically reduced the number of extensive soft tissue releases performed in selected centers in both economically developed and underdeveloped regions [1-4, 6-14, 16-19, 28].…”

Section: Discussionmentioning

confidence: 99%

Ponseti Method for Untreated Idiopathic Clubfeet in Nepalese Patients From 1 to 6 Years of Age

Spiegel

Shrestha

Sitoula

et al. 2009

Clinical Orthopaedics &Amp; Related Research

100

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Although the Ponseti method has been effective in patients up to 2 years old, limited information is available on the use of this method in older patients. We retrospectively reviewed the records of 171 patients (260 feet) to determine whether initial correction of the deformity (a plantigrade foot) could be achieved using the Ponseti method in untreated idiopathic clubfeet in patients presenting between the ages of 1 and 6 years. A mean of seven casts was required, and there were no differences in the number of casts between the different age groups. Two hundred fifty (95%) of the 260 feet were treated surgically for residual equinus after a plateau in casting, and procedures included percutaneous tendo-Achilles release

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“…Correction of vertical talus through an open reduction can be associated with significant short-term complications, including wound necrosis [1], undercorrection of the deformity [34], stiffness of the ankle and subtalar joint [49], and the eventual need for multiple operative procedures such as subtalar and triple arthrodesis [47]. Long-term outcomes are likely to be complicated by a significant amount of degenerative arthritis as is seen in many patients with clubfoot treated with extensive soft-tissue releases [50]. The exact upper age limit for a successful open reduction is not known.…”

Section: Traditional Surgical Treatmentmentioning

confidence: 99%

A new approach to the treatment of congenital vertical talus

Alaee

Boehm

Dobbs

2007

Journal of Children's Orthopaedics

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Congenital vertical talus is an uncommon foot deformity that is present at birth and results in a rigid flatfoot deformity. Left untreated the deformity can result in pain and disability. Though the exact etiology of vertical talus is unknown, an increasing number of cases have been shown to have a genetic cause. Approximately 50% of all cases of vertical talus are associated with other neuromuscular abnormalities or known genetic syndromes. The remaining 50% of cases were once thought to be idiopathic in nature. However, there is increasing evidence that many of these cases are related to single gene defects. Most patients with vertical talus have been treated with major reconstructive surgeries that are fraught with complications such as wound necrosis, talar necrosis, undercorrection of the deformity, stiffness of the ankle and subtalar joint, and the eventual need for multiple operative procedures. Recently, a new approach to vertical talus that consists of serial casting and minimal surgery has resulted in excellent correction in the short-term. Longer follow-up will be necessary to ensure maintenance of correction with this new technique. A less invasive approach to the correction of vertical talus may provide more favorable long-term outcomes than more extensive surgery as has been shown to be true for clubfoot outcomes.

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Long-Term Follow-up of Patients with Clubfeet Treated with Extensive Soft-Tissue Release

Abstract: "Long-term follow-up of patients with clubfeet treated with extensive soft-tissue release." The Journal of Bone and Joint Surgery.88,5. 986-996. (2006

Cited by 221 publications

References 63 publications

Ponseti Treatment for Idiopathic Clubfoot: Minimum 5-year Followup

Ponseti Treatment for Idiopathic Clubfoot: Minimum 5-year Followup

Ponseti Method for Untreated Idiopathic Clubfeet in Nepalese Patients From 1 to 6 Years of Age

A new approach to the treatment of congenital vertical talus

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