Is it Possible to Treat Recurrent Clubfoot with the Ponseti Technique After Posteromedial Release?: A Preliminary Study

Nogueira, Monica Paschoal; Batlle, Anna Maria Ey; Alves, Cristina

doi:10.1007/s11999-009-0718-9

Cited by 45 publications

(20 citation statements)

References 22 publications

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“…With respect to the non-compliance rate and relapse rate, a variety of medical centers and researches reported different findings. Many authors reported that brace intolerance ranges from 0% to 51% 3,6,7,8,10,20,25,27). In the research by Haft et al,25) the non-compliance rate was 49% and patients who did not adhere to the bracing protocol were 5 times more likely to have a relapse in comparison with children who wore the brace regularly.…”

Section: Relapse After Full Correction and Non-compliance With Brace mentioning

confidence: 99%

Relapse of Clubfoot after Treatment with the Ponseti Method and the Function of the Foot Abduction Orthosis

et al. 2014

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Ponseti clubfoot treatment has become more popular during the last decade because of its high initial correction rate. But the most common problem affecting the long-term successful outcome is relapse of the deformity. Non-compliance with Ponseti brace protocol is a major problem associated with relapse. Although more comfortable braces have been reported to improve the compliance, they all have the same design and no significant changes have been made to the protocols. After refinement in the Ponseti method and emphasizing the importance of brace to parents, the relapse rate has been markedly decreased. Nevertheless, there are patients who do not have any recurrence although they are not completely compliant with the brace treatment, whereas other patients have a recurrence even though they are strictly compliant with the brace treatment. The aim of this article is to review the relapse of clubfoot and the function of the brace and to develop an individualized brace protocol for each patient by analyzing the mechanism of the brace and the biomechanical properties of muscles, tendons, and ligaments.

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Section: Relapse After Full Correction and Non-compliance With Brace mentioning

confidence: 99%

Relapse of Clubfoot after Treatment with the Ponseti Method and the Function of the Foot Abduction Orthosis

et al. 2014

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“…Nagaraju report that when treating 18 feet from 13 patients via the Ponseti method, they achieve well-formed plantigrade feet where previously they had used the Kite method and experienced recurrences of the disease [27]. Nogueira reports that for patients who had unsuccessful surgical treatments, 71 out of 83 feet (86%) were corrected with the Ponseti method and the patients developed plantigrade, fully corrected feet [28]. Recurrences of the deformity are characterized as metatarsus adductus, abduction of foot, loss of dorsiflexion, and dynamic supination, which appears during gait analysis when the patient is walking.…”

Section: Citation: Sayit E Sayit At (2015) Clinical Experiences and mentioning

confidence: 99%

Clinical Experiences and Midterm Results of the Treatment of Clubfoot with the Ponseti Method

Sayıt¹

2015

ORP

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IntroductionTalipes Equinovarus (TEV) is a fairly common birth defect in which males are affected twice as often as females and 50% of the cases show bilateral defects [1]. In the United States, the overall prevalence of clubfoot is 1.29 per 1000 live births [2].Although the Ponseti method of treatment was first described many years ago, it recently became the standard method of treating TEV due to its successful long-term results.Several scoring methods have been developed to assess the foot before, during, and after treatment for TEV. For this study, we incorporated data from two of the most commonly used scoring systems, Dimeglio and Pirani. Dimeglio and his colleagues divide a clubfoot deformity into four measurable anatomical features, or subgroups, which are scored on a scale of 20 points. These subgroups are equinus in the sagittal plane, varus deviation in the frontal plane, derotation around the talus of the calcaneo-forefoot block, and adduction of the forefoot on the hindfoot in the horizontal plane. Each subgroup is assessed in severity from 1 to 4 points. In the presence of a posterior or medial fold, extreme cavus and/or muscle weakness, another point is added to each category for a possible total of 5 points [3]. The second scale, the Pirani scoring system, evaluates six parameters of the foot separately as normal (0 points), moderate to severe (0.5 points), or severe (1 point). These anatomical parameters are the curvature of the lateral border of the foot, degree of medial skin fold, covering of the head of talus, degree of posterior skin fold, equinus or extreme plantar flexion at the ankle joint, and the presence of a free heel [4]. The Dimeglio and Pirani scoring systems are useful in evaluating the degree of correction of the foot as well as the potential for the prognosis of the disease.In the following study, we examine the components of the Ponseti method and share our experiences and results. Materials and MethodsIn this study, we analyzed 92 feet from a total of 60 patients with idiopathic talipes equinovarus. Of the total, 43 patients were males and 17 were females. All patients started treatment with the Ponseti method on the same day that they presented to our clinic. Patients with accompanying anomalies or dysmelias were excluded. The patients' families were given detailed information regarding the clubfoot deformation as well as the Ponseti treatment process, other available treatment options, the usage of orthoses, possible complications, and the potential prognosis. We explained how crucial the family's compliance and cooperation are to the success of the treatment and collected the family's fully informed consent.For casting the legs after manipulation, we used the classic casting method of combining 5 or 10 cm of cotton with plaster of Paris. No synthetic casting materials were used. A trained orthopedic surgeon and a resident performed the Ponseti manipulations. We encouraged feeding of the infants prior to cast molding and placement. HSOA Journal of Orthopedic Research and P...

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“…94 The Ponseti method 1,4,53 , composed basically of manipulations and serial plaster cast changes, percutaneous sectioning of the calcaneal tendon and use of abduction orthosis, has become the preferential method for the treatment of idiopathic CC in many countries, in the last ten years (Bor; Bor, 2002). With widespread acceptance, it was extended for use on older children [95][96][97][98] ; complex and resistant feet 99 ; relapsed feet 100 , including relapses after extensive surgical release 101 , and also, in non-idiopathic cases, such as in myelomeningocele 102,103 and distal arthrogryposis 104,105 . The grounds of the manipulation technique consist of correcting deformities by means of the plastic change of the contractured and shortened elements, which have a high elastic capacity in the younger child.…”

Section: Ponseti's Methodsmentioning

confidence: 99%

“…However, the upper age limit, both for treatment using the Ponseti method, and for the performance of percutaneous tenotomy, is not well established. The use of the Ponseti method was also extended to relapsed feet, including after surgical releases, with reports of good outcomes 101 .…”

Section: Older Children and Relapsed Feetmentioning

confidence: 99%

Pé torto congênito

Maranho

Volpon

2011

Acta ortop. bras.

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The clubfoot is one of the most common congenital deformities affecting the lower limbs, it still presents controversial aspects regarding etiology and treatment. In spite of its relatively high frequency, the treatment is still challenging, since the long-term aim is achieving an everlasting flexible, plantigrade, pain-free and totally functional foot. The Ponseti method has gained attention and popularity because of its satisfactory results and surgery avoidance. Presently, surgical treatment is indicated only after failure of conservative methods, avoiding extensive soft-tissue release, but performing localized corrections of the deformities, a technique also know as "a la carte" release. The future perspective is based on the knowledge about long-term results and new understanding of the clubfoot etiology, especially in the genetic field, which may eventually be helpful for prognostic and treatment. Level of Evidence: Level II, systematic review.

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Is it Possible to Treat Recurrent Clubfoot with the Ponseti Technique After Posteromedial Release?: A Preliminary Study

Cited by 45 publications

References 22 publications

Relapse of Clubfoot after Treatment with the Ponseti Method and the Function of the Foot Abduction Orthosis

Relapse of Clubfoot after Treatment with the Ponseti Method and the Function of the Foot Abduction Orthosis

Clinical Experiences and Midterm Results of the Treatment of Clubfoot with the Ponseti Method

Pé torto congênito

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