Our Experiences with the Early Operative Treatment of Congenital Clubfoot

Franke, Jürgen; Hein, G.

doi:10.1097/01241398-198801000-00007

Cited by 18 publications

(8 citation statements)

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“…To correct the varus and adduction, the foot in supination is abducted while counterpressure is applied with the thumb against the head of the talus. Four to seven long leg casts, changed weekly after proper manipulation of the foot, are usually sufficient to obtain good correction 6,13,23 . In the last cast, the foot should be markedly abducted (70°) without pronation.…”

Section: Treatment Regimenmentioning

confidence: 99%

Factors Predictive of Outcome After Use of the Ponseti Method for the Treatment of Idiopathic Clubfeet

Dobbs

Rudzki

Purcell

et al. 2004

The Journal of Bone and Joint Surgery-American Volume

451

410

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Section: Treatment Regimenmentioning

confidence: 99%

Factors Predictive of Outcome After Use of the Ponseti Method for the Treatment of Idiopathic Clubfeet

Dobbs

Rudzki

Purcell

et al. 2004

The Journal of Bone and Joint Surgery-American Volume

451

410

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“…Though better results were obtained by posterior and posteromedial soft tissue release in younger children it has been suggested that early surgical treatment lead to severe fibrosis and development of rigid foot. Thus surgery should better be executed between 1 and 2 years of child age 6,7,8 .…”

Section: Observation and Resultsmentioning

confidence: 99%

“…In a study by Jack C. Y. Cheng, 30 of 70 feet he reported excellent in 60%, good in 18.6%, fair in 11% and poor in 11.4%. Gokmen Deniz et al, 6 reported that in his series with 35 feet he found excellent in 16 feet (45.7%), good in 11 feet(31.4%), moderate in 3 feet(8.6%) and poor in 5 feet (14.3%). The functional results were evaluated at the end of the study showed excellent in 6 feet (25%), good in 12 feet (50%), fair in 5 feet (20.83%) and poor in 1 foot (4.17%).…”

Section: Evaluation Of Rommentioning

confidence: 99%

“…6,14 Karakurt et al described skin necrosis in 15% and deep necrosis including Achilles tendon in 6%. Dimeglo reported no necrosis in 91 cases.…”

Section: Skin Necrosismentioning

confidence: 99%

“…Dimeglo reported no necrosis in 91 cases. 6,15 Zhon-Liau Lee has reported skin problem in 11 feet in total of 60 feet (18.3%). Among them 7 feet had mild patchy necrosis, 3 feet had moderate necrosis and one foot had extensive skin necrosis, wound dehiscence and deep infection.…”

Section: Skin Necrosismentioning

confidence: 99%

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A Prospective Study of Surgical Correction of Ctev by Cincinnati Approach

Gopalakrishna¹,

Manjunath²,

Chandrashekar³

2014

jemds

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BACKGROUND: Surgical correction of congenital talipes equino varus (ctev) is to address adequately all aspects of this complex foot deformity. Various exposures have been elucidated with varying results and complications. This prospective study discusses the cincinnati approach advocated by Mackay to address the various aspects of clubfoot correction. Objective: To study the adequacy of exposure, wound healing and problems related to Cincinnati approach. To study the effectiveness of primary surgical correction. METHODS: The present prospective study includes treatment of 24 feet in 21 patients with clubfoot treated with posteromedial and lateral soft tissue release by Cincinnati approach and followed up with an average follow up of 6.9 months. 3 (12.5%) were followed up for 1 year and 3 (12.5%) lost for the follow up. 18 (75%) were followed up to 6 months. All were resistant to correction by conservative method. Age at operation averaged 1.6 year, ranged from 9 months to 3 years. RESULTS: Results were evaluated using Laaveg and Ponseti functional rating system of clubfoot. Postoperatively the average arc of movement in ankle joint was 37 0 , which was 50% of normal limb. Inversion, eversion movement of subtalar joint was 23 0 , bimalleolar angle was 77 0 .The functional results were excellent in 6 feet (25%), good in 12 feet (50%), fair in 5 feet (20.83%) and poor in 1 foot (4.17%). In our series complications encountered were post-operative focal necrosis in 3 feet (12.5%) and marginal necrosis in 3 feet (12.5%). CONCLUSION: Cincinnati incision provides an adequate exposure for extensive surgical release under direct vision, there by bony realignment of talus over calcaneus was restored and hence the restoration of normal bimalleolar angle. Skin closure is not found to be a problem in achieving a primary closure. Wound healing leaves only a thin and cosmetically acceptable scar.

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