Posteromedial Release for Idiopathic Talipes Equinovarus

Levin, Mark N.; Kuo, Ken N.; Harris, Gerald F.; Matesi, D.V.

doi:10.1097/00003086-198905000-00027

Cited by 34 publications

(11 citation statements)

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“…Many previous studies of clubfeet treated with an extensive soft-tissue release showed good early results, but the followup in those studies was limited and in no series were the patients followed into adulthood 4,5,7,8,13,19,31,32,[57][58][59][60] . The few studies in which patients were followed to skeletal maturity showed that the early results obtained with an extensive soft-tissue release deteriorate with time 13,31,32 , indicating that longer follow-up is necessary to evaluate the lifelong function of a surgically treated clubfoot.…”

Section: Discussionmentioning

confidence: 99%

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

Dobbs

Nunley

Schoenecker

2006

The Journal of Bone & Joint Surgery

221

187

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Section: Discussionmentioning

confidence: 99%

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

Dobbs

Nunley

Schoenecker

2006

The Journal of Bone & Joint Surgery

221

187

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“…Although some studies have reported on pain and function in patients treated with the Ponseti method [1,5,13,22,28] and others have reported on the comprehensive surgical release [1,5,8,9,11,12,17,23,26,29,31,32,35,37], to our knowledge no study has compared these approaches using focused functional and biomechanical analyses, and none has compared quality-of-life measures for patients who had these approaches with those of individuals with normal feet. Such comparisons are important, as the patients treated with these two methods during the 1980s and 1990s are now young adults in the workforce.…”

Section: Introductionmentioning

confidence: 99%

Long-term Results of Comprehensive Clubfoot Release Versus the Ponseti Method: Which Is Better?

Smith

Kuo

Graf

et al. 2014

Clinical Orthopaedics &Amp; Related Research

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Background Clubfoot can be treated nonoperatively, most commonly using a Ponseti approach, or surgically, most often with a comprehensive clubfoot release. Little is known about how these approaches compare with one another at longer term, or how patients treated with these approaches differ in terms of foot function, foot biomechanics, or quality-of-life from individuals who did not have clubfoot as a child. Questions/purposes We compared (1) focused physical and radiographic examinations, (2) gait analysis, and (3) quality-of-life measures at long-term followup between groups of adult patients with clubfoot treated either with the Ponseti method of nonsurgical management or a comprehensive surgical release through a Cincinnati incision, and compared these two groups with a control group without clubfoot. Methods This was a case control study of individuals treated for clubfoot at two separate institutions with different methods of treatment between 1983 to 1987. One hospital used only the Ponseti method and the other mainly used a comprehensive clubfoot release. There were 42 adults (24 treated surgically, 18 treated with Ponseti method) with isolated clubfoot along with 48 healthy control subjects who agreed to participate in a detailed analysis of physical function, foot biomechanics, and quality-of-life metrics. Results Both treatment groups had diminished strength and motion compared with the control subjects on physical examination measures; however, the Ponseti group had significantly greater ankle plantar flexion ROM (p \ 0.001), greater ankle plantar flexor (p = 0.031) and evertor (p = 0.012) strength, and a decreased incidence of osteoarthritis in the ankle and foot compared with the surgical group. During gait the surgical group had reduced peak ankle plantar flexion (p = 0.002), and reduced sagittal plane hindfoot (p = 0.009) and forefoot (p = 0.008) ROM during the preswing phase compared with the Ponseti group. The surgical group had the lowest overall ankle power generation during push off compared with the control subjects (p = 0.002). Outcome tools revealed elevated pain levels in the surgical group compared with the Ponseti group (p = 0.008) and lower scores for physical function and quality-of-life for both clubfoot groups compared with age-range matched control subjects (p = 0.01).

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“…Both nonoperative methods of manipulation [3][4][5] and extensive soft-tissue releases [6][7][8][9][10][11][12][13][14][15][16] have been advocated. Early methods of manipulation, such as the Kite technique 3 , demonstrated inconsistent results, leading to unpredictable outcomes after extended periods of casting.…”

mentioning

confidence: 99%

“…Extensive surgical releases 6,9 were proposed in order to avoid the complications and duration of the casting techniques. Despite the initial correction of the deformity, these surgical releases often led to variability in short-term outcome 6,12 , the need for revision procedures 8,9 , and significant limitations at the time of long-term follow-up 15,16 . The Ponseti method 17,18 involves the use of serial casting to gradually correct the clubfoot deformity and a percutaneous tenotomy of the Achilles tendon to correct residual ankle equinus, followed by several years of foot abduction bracing to maintain correction.…”

mentioning

confidence: 99%

Early Results of the Ponseti Method for the Treatment of Clubfoot Associated with Myelomeningocele

Gerlach

Gurnett

Limpaphayom

et al. 2009

The Journal of Bone and Joint Surgery-American Volume

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Posteromedial Release for Idiopathic Talipes Equinovarus

Cited by 34 publications

References 0 publications

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

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

Long-term Results of Comprehensive Clubfoot Release Versus the Ponseti Method: Which Is Better?

Early Results of the Ponseti Method for the Treatment of Clubfoot Associated with Myelomeningocele

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