Acta Ortopédica Mexicana

Méndez-Tompson M, Olivares-Becerril O, Preciado-Salgado M, Quezada-Daniel I, Vega-Sánchez JG
Management of congenital adduct clubfoot with the Ponseti technique. Experience at «La Perla» General Hospital
Acta Ortop Mex 2012; 26 (4)

Language: Español
References: 10
Page: 228-230
PDF: 32.93 Kb.

[Fulltext - PDF]

ABSTRACT

The purpose of this paper is to present the experience of the hospital using the Ponseti method in patients with congenital adduct clubfoot. Material and methods: The study was conducted between January 2007 and December 2009. Children of both sexes were included; the Dimeglio classification was applied before surgery and their course was later assessed with the Simons scale when they resumed gait. Patients with postural clubfoot (Dimeglio I) and those with neuromuscular disease (Dimeglio IV) were excluded. Casts were placed as of 15 days of age using the Ponseti technique and then percutaneous tenotomy of the calcaneous tendon was performed in the operating room. Results: Twenty patients (9 girls, 11 boys) and 28 feet were included in the study; they were Dimeglio II (8 children) and III (12 children). Mean age at the time of surgery was 2 months, and mean age at the time of gait assessment was 2 years. Upon applying the Simons scale, 25 feet (89.3%) had satisfactory results and 3 feet (10.7%) unsatisfactory results. Two of the latter underwent percutaneous tenotomy again and in one case the cast was applied again; they evolved properly. Conclusions: We found in our series that the Ponseti technique is appropriate as definitive treatment for Dimeglio II and III congenital adduct clubfoot.


Key words: clubfoot, technique, child, evaluation, Achilles tendon, average.


REFERENCES

  1. Mihran O, Tachjian MA: Ortopedia pediátrica. 2ª ed. vol. IV. España: McGraw-Hill Interamericana; 1994: 2621-710.

  2. Ponseti IV, Smoley EN: Congenital clubfoot: The results of treatment. J Bone Joint Surg 1963; 45A: 261-5.

  3. Ponseti IV: Current concepts review. Treatment of congenital clubfoot. J Bone Joint Surg 1992; 74A: 448-54.

  4. Sharck N, Eastwood DM: Early results of a physiotherapist-delivered Ponseti service for the management of idiopathic congenital talipes equinovarus foot deformity. J Bone Joint Surg Br 2006; 88(8): 1085-9.

  5. Morcuende JA, Dolan LA, Dietz FR: Radical reduction in the rate of extensive corrective surgery for clubfoot using the Ponseti method. Pediatrics 2004; 113(2): 376-80.

  6. Dimeglio A, Bensahel H, Souchet P, Mazeau P, Bonnet F. Classification of clubfoot. J Pediatr Orthop B 1995; 4(2): 129-36

  7. Simons G: Complete subtalar release in club feet Part I-A: Preliminary report. J Bone Joint Surg 1985; 67A: 1044-55.

  8. Zionts LE, Zhao G, et al: Has the rate of extensive surgery to treat idiopathic clubfoot declined in the United States? J Bone Joint Surg Am 2010; 92(4): 882-9.

  9. Dogan A, Kalender AM, et al: Mini-open technique for the Achille tenotomy in correction of idiopathic clubfoot: a report of 25 cases. J Am Podiatr Med Assoc 2008; 98(5): 414-7.

  10. Dobbs MB, Rudzki JR, et al: Factors predictive of outcome after use of Ponseti method for the treatment of idiopathic clubfeet. J Bone Joint Surg Am 2004; 86-A(1): 22-7.