Harb PEJ, Méndez TM, Sierra CR

Language: Spanish
References: 8
Page: 313-317
PDF size: 274.50 Kb.

ABSTRACT

Looking for a simpler solution for the equine varus congenital foot (EVCF), we intended to prove the method of manipulation and immobilization as well as the practice, to early age, of the percutaneous tenotomy of the Achilles tendon proposed by Ponseti and their group. Between January of 1995 and December of 1997, they were first treated by the author (EHP) a total of 68 equine varus congenital feet, carrying out in all the method of manipulation and immobilization proposed by Ponseti. The time of follow-up was a minimum of 4 and a maximum of 7 years. In any foot a total correction was achieved needing all of some type of surgical liberation; 24 feet required percutaneous tenotomy of the Achilles tendon, 9 later liberation and 35wide liberation, with satisfactory results, according to the scale of Simons, in 22, 8 and 32 feet respectively. By means of this system we diminish in 32.3% the necessity of liberation of soft parts. We have noticed that while we improve the technique of manipulation and plaster moulding the percentage of feet that only need of a percutaneous tenotomy of the Achilles tendon increases year after year, and after 7 years of having adopted the method of Ponseti, we can affirm that we have limited the biggest surgical procedures (later liberation, postero-medial liberation) to less than 40% of our cases.

REFERENCES

1. Bensahel H, Guillaume A, Csukonyi Z, Themar-Noel C. The intimacy of clubfoot: The ways of functional treatment. J Pediatr Orthop part B 1994; 3(2): 155-160.

2. Harb E, Sierra R. Consideraciones sobre el tratamiento quirúrgico del pie equinovaro congénito. Rev Mex Ortop Traum 1996; 10(1): 5-8.

3. Morcuende JA, Weinstein SL, Dietz FR, Ponseti IV. Plaster cast treatment of clubfoot: the Ponseti method of manipulation and casting. J Pediatr Orthop part B 1994; 3(2): 161-167.

4. Ponseti IV, Smoley EN. Congenital clubfoot: the results of treatment. J Bone Joint Surg 1963; 45A(2): 261-275.

5. Ponseti IV. Current concepts review. Treatment of congenital clubfoot. J Bone Joint Surg 1992; 74A(3): 448-454.

6. Simons GW. Complete subtalar release in club feet. Part II. Comparison of less extensive procedures. J Bone Joint Surg 1985; 67A: 1056-1065.

7. Thompson GH, Richardson AB, Westin GW. Surgical management of resistant congenital talipes equinovarus deformities. J Bone Joint Surg 1982; 64A(5): 652-665.

8. Turco VJ. Present management of idiopathic clubfoot. J Pediatr Orthop part B 1994; 3(2): 149-154.