Journal article
Treatment of the complex idiopathic clubfoot
Clinical orthopaedics and related research, Vol.451(451), pp.171-176
2006
DOI: 10.1097/01.blo.0000224062.39990.48
PMID: 16788408
Abstract
Treatment with the Ponseti method corrects congenital idiopathic clubfeet in the majority of patients. However, some feet do not respond to the standard treatment protocol. We describe the characteristics and treatment results of these complex idiopathic clubfeet. We identified 50 patients (75 clubfeet) from 762 consecutive patients treated at five institutions. Clinically, complex clubfeet were defined as having rigid equinus, severe plantar flexion of all metatarsals, a deep crease above the heel, a transverse crease in the sole of the foot, and a short and hyperextended first toe. The Achilles' tendon was exceptionally tight and fibrotic up to the middle of the calf. Correction was achieved in all patients by modifying the Ponseti manipulation and casting technique. Correction required an average of five casts (range, 1-10 casts). Two patients (4%) not initially recognized as having complex clubfeet had a posterior release with tendo Achillis lengthening. There were seven relapses that responded to casting. Three patients had a second tenotomy. Modifying the treatment protocol for complex clubfeet successfully corrected the deformity without the need for extensive corrective surgery.
Details
- Title: Subtitle
- Treatment of the complex idiopathic clubfoot
- Creators
- Ignacio V PONSETI - Department of Orthopaedic Surgery and Rehabilitation, University of Iowa, Iowa City, IA, United StatesMiroslav ZHIVKOV - University Hospital Saint Anna,, Varna, BulgariaNaomi DAVIS - Booth Hall Children's Hospital, Manchester, United KingdomMarc SINCLAIR - Altonaer Kinderkrankenhaus, Hamburg, GermanyMatthew B DOBBS - Department of Orthopae dic Surgery, Washington University, St. Louis. MO, United StatesJose A MORCUENDE - Department of Orthopaedic Surgery and Rehabilitation, University of Iowa, Iowa City, IA, United States
- Resource Type
- Journal article
- Publication Details
- Clinical orthopaedics and related research, Vol.451(451), pp.171-176
- Publisher
- Springer; Heidelberg
- DOI
- 10.1097/01.blo.0000224062.39990.48
- PMID
- 16788408
- ISSN
- 0009-921X
- eISSN
- 1528-1132
- Language
- English
- Date published
- 2006
- Academic Unit
- Stead Family Department of Pediatrics; Orthopedics and Rehabilitation
- Record Identifier
- 9984040599902771
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