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Acta Ortopédica Mexicana

ISSN 2992-8036 (Electronic)
ISSN 2306-4102 (Print)
Órgano Oficial del Colegio Mexicano de Ortopedia y Traumatología
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2012, Number 2

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Acta Ortop Mex 2012; 26 (2)

Posterior release in congenital talipes equinovarus adductus

Fuentes-Nucamendi MA, Camarena-Hernández HP, Bonfil-Ojeda JR, Martínez-Bonilla E
Full text How to cite this article

Language: Spanish
References: 11
Page: 77-84
PDF size: 178.92 Kb.


Key words:

clubfoot congenital, surgery, technique.

ABSTRACT

Objective: To show the utility of posterior release to correct adduct congenital talipes equinovarus (CTE) and describe the surgical technique. Material and methods: This clinical trial was conducted from February 2002 to November 2008. Patients ages 0-24 months old with a diagnosis of adduct CTE were enrolled. Surgical treatment consisted of a posterior approach to the foot with Z-plasty of the tibialis posterior, flexor digitorum longus and flexor hallucis longus, capsulotomy, adductor hallucis release, and cast immobilization for 8 weeks. Analysis: The sampling was non-randomized, non-probabilistic; patients were enrolled based on the diagnosis. The statistical analysis included the central trend and scatter measures, the Student «t» test, RR, and homogeneity chi square test. Results: Twenty-five patients were enrolled, 13 females and 12 males, with a total of 30 feet, 10 left and 6 right, and 7 bilateral patients. Median age was 15 years (range 11-24 years). Correction was achieved and maintained in 27 feet. Three cases had adduct relapse and were managed conservatively. The statistical analysis showed the effectiveness of treatment. The result of the Student «t» test and the chi square test was p ‹ 0.0002. Discussion: The proposed treatment was effective to correct the adduct CTE, with a proven effectiveness of more than 90% in the patients included in this study. The age of onset of treatment › 18 months was a risk factor for residual adduct with a RR = 3.7.


REFERENCES

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  3. Scher MA, Handelsman JE, Issacs H: The effect on muscle of immobilization under tension and relaxation. J Bone Joint Surg Br 1977; 59: 257.

  4. Waisbrod H: Congenital club foot, an anatomical study. J Bone Joint Surg Br 1973; 55: 796-801.

  5. Crenshaw AHC: Cirugía ortopédica. Séptima edición. Buenos Aires, Argentina. Editorial Médica Panamericana; 1984: 2594-5.

  6. Mackay DW: New concept of an approach to clubfoot treatment: Section I– Principles an morbid anatomy. J Pediatr Orthop 1982; 2: 347-56.

  7. Mackay DW: New concept of an approach to clubfoot treatment: Section II– Correction of the clubfoot. J Pediatr Orthop 1983; 3: 10-21.

  8. Mackay DW: New concept of an approach to clubfoot treatment: Section III– Evaluation and results. J Pediatr Orthop 1983; 3: 141-8.

  9. Turco VJ: Surgical correction of the resistant clubfoot, one-stage posteromedial release with internal fixation. J Bone Joint Surg Am 1971; 53: 477-97.

  10. Sherman FC, Westin GW: Plantar release in the correction of deformities of the clubfoot in childhood. J Bone Joint Surg Am 1981; 63: 1382-9.

  11. Swann M, Lloyd-Roberts GC, Catterall A: The anatomy of uncorrected clubfeet. A study of rotation deformity. J Bone Joint Surg Br 1969; 51: 263-9.




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Acta Ortop Mex. 2012 Mar-Abr;26