medigraphic.com
ISSN 2007-087X (Print)
Órgano Oficial de la Sociedad Mexicana de Ortopedia Pediátrica

2011, Number 1

<< Back Next >>

Rev Mex Ortop Ped 2011; 13 (1)

Impact of Ponseti’s method in primary surgery of congenital adduct club foot at Shriners Hospital for Children, Mexico City

Torres-Gómez A, Cassis ZN

Language: Spanish
References: 16
Page: 28-31
PDF size: 55.73 Kb.


ABSTRACT

Background: The Ponseti method has been worldwide adopted as the standard treatment of congenital clubfoot (CF). In our hospital, this method was introduced in 2005. We sought to investigate the impact in our hospital of the systematic implementation of the Ponseti method as the standard treatment of CF in the primary surgery: Postero medial release (PMR). Methods: We revised the total number of surgeries performed at the Shriners Hospital for Children, Mexico City in a period of 10 years, from 2000 to 2009, and the PMR performed in this period. Absolute and relative frequencies were analyzed, rate adjustments were performed with a probabilistic approach. We considered two 5 year periods: from 2000 to 2004 and from 2005 to 2009, marked by the introduction of the Ponseti method. Proportions were analyzed with a binomial test. Results: During the studied period, 31,671 surgeries were performed, 3,387 patients were admitted with the diagnosis of CF, of which 1,082 underwent a PMR. During the 1st period, 870 PMRs were performed (5.8% of all operations), compared to 212 PMRs in the 2nd period (1.27% of all operations), (p ‹ 0.001). This represents a relative reduction of 78.17% in the PMRs performed. From a different standpoint, in the 1st period 60.01% of admitted patients with a CF diagnosis, underwent a PMR, compared with a mere 8.60% in the 2nd period (p ‹ 0.001). This represents a relative decrease in 85.53% on the PMRs performed on patients admitted with a CF diagnosis. Conclusions: Following the introduction of the Ponseti method of the treatment of CF, of PMRs declined in 85.53% in the Shriners Hospital for Children, Mexico City.


REFERENCES

  1. Dobbs MB, Gurnett CA. Update on clubfoot: etiology and treatment. Clin Orthop Relat Res 2009; 467(5): 1146-53.

  2. Cardy AH, Barker S, Chesney D, Sharp L, Maffulli N, Miedzybrodzka Z. Pedigree analysis and epidemiological features of idiopathic congenital talipes equinovarus in the United Kingdom: a case-control study. BMC Musculoskelet Disord 2007; 8: 62.

  3. Carey M, Bower C, Mylvaganam A, Rouse I. Talipes equinovarus in Western Australia. Paediatr Perinat Epidemiol 2003; 17(2): 187-94.

  4. Wynne-Davies R. Family studies and the cause of congenital club foot. Talipes equinovarus, talipes calcaneo-valgus and metatarsus varus. J Bone Joint Surg Br 1964; 46: 445-63.

  5. Torres-Gómez A, Pérez-Salazar-Marina D, Cassis N. Pie equino varo aducto congénito, prevalencia en una población mexicana. Rev Mex Ortop Pediatr 2010; 12(1): 4.

  6. Lochmiller C, Johnston D, Scott A, Risman M, Hecht JT. Genetic epidemiology study of idiopathic talipes equinovarus. Am J Med Genet 1998; 79(2): 90-6.

  7. Ponseti IV, Smoley EN. The classic: congenital club foot: the results of treatment. 1963. Clin Orthop Relat Res 2009; 467(5): 1133-45.

  8. Cassis N, Torres-Gomez A. Treatment options for clubfoot: An update. Pediatric Health 2009; 3(5): 6.

  9. Aronson J, Puskarich CL. Deformity and disability from treated clubfoot. J Pediatr Orthop 1990; 10(1): 109-19.

  10. Atar D, Lehman WB, Grant AD. Complications in clubfoot surgery. Orthop Rev 1991; 20(3): 233-9.

  11. Dobbs MB, Morcuende JA, Gurnett CA, Ponseti IV. Treatment of idiopathic clubfoot: an historical review. Iowa Orthop J 2000; 20: 59-64.

  12. Dobbs MB, Nunley R, Schoenecker PL. Long-term follow-up of patients with clubfeet treated with extensive soft-tissue release. J Bone Joint Surg Am 2006; 88(5): 986-96.

  13. Hutchins PM, Foster BK, Paterson DC, Cole EA. Long-term results of early surgical release in club feet. J Bone Joint Surg Br 1985; 67(5): 791-9.

  14. Ippolito E, Farsetti P, Caterini R, Tudisco C. Long-term comparative results in patients with congenital clubfoot treated with two different protocols. J Bone Joint Surg Am 2003; 85-A(7): 1286-94.

  15. Weseley MS, Barenfeld PA, Barrett N. Complications of the treatment of clubfoot. Clin Orthop Relat Res 1972; 84: 93-6.

  16. Torres-Gómez A, Saleme J, Cassis N, Di Silvio M. Análisis de impacto presupuestal del método de Ponseti para el tratamiento del pie equino varo aducto congénito. Congreso Internacional “Actualización en los Principales Retos de Salud en el México del Siglo XXI”, Centro Médico Nacional “20 de Noviembre”; México, DF. 2011.




2020     |     www.medigraphic.com