Management of foot deformity in children

Machida, Jiro; Inaba, Yutaka; Nakamura, Naoyuki

doi:10.1016/j.jos.2016.12.009

Cited by 18 publications

(16 citation statements)

References 26 publications

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“…This is because there is a general untoward tendency to publish studies with significant results and leave studies with insignificant or negative results [13]. There are striking similarities between congenital talipes equinovarus and CVT in regard to the complication potential following extensive soft tissue release for the nonisolated, recurrent, multiply operated and/or simply late-presenting categories above the age of two years [12,14,15]. In light of the growing consensus that the current treatment recommendations for such CVT subtypes are vague, we proposed our new strategy, namely, naviculectomy/midtarsal resection with limited soft tissue release.…”

Section: Discussionmentioning

confidence: 99%

Naviculectomy for two ambulatory children with intractable congenital vertical talus: redefining the indications of an old technique

El-Sobky

Samir²,

Mahmoud³

2019

Journal of Pediatric Orthopaedics B

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Congenital vertical talus is a rare and complex foot anomaly. Serial casting with or without minimally invasive surgery is a universal management strategy especially for children in the first year of life. Nevertheless, extensive surgical treatment of late-presenting, neglected and multiple operated children with congenital vertical talus may be required with guarded results. The results of naviculectomy as a more conservative intervention and directed exclusively at ambulatory children with intractable congenital vertical talus have not been reported. We present the radioclinical outcomes of two ambulatory children with intractable congenital vertical talus treated by naviculectomy/midtarsal resection and limited soft tissue release. One child had an isolated congenital vertical talus whereas the other had a nonisolated etiology. Generally, naviculectomy/midtarsal resection revealed a positive benefit-risk profile in children with intractably severe congenital vertical talus on the short-term. We reported favorable results in terms of foot appearance, function and radiology. We believe that a less invasive procedure like naviculectomy/midtarsal resection is an encouraging technique to investigate in children with intractable congenital vertical talus.

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Section: Discussionmentioning

confidence: 99%

Naviculectomy for two ambulatory children with intractable congenital vertical talus: redefining the indications of an old technique

El-Sobky

Samir²,

Mahmoud³

2019

Journal of Pediatric Orthopaedics B

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“…Sebelumnya diperlukan foto radiologik posisi anteroposterior (AP) kaki dalam posisi abduksi dan posisi lateral kaki dalam posisi dorsifleksi maksimal dan fleksi plantar. 13 Terapi deformitas terdiri dari manipulasi ringan pada kaki dan serial casting dengan maksimal 10 kali menggunakan long-leg cast setiap minggunya.…”

Section: Skor Kontraktur Kaki Bagian Tengahunclassified

“…Selama masa ini, akan didapatkan hasil jelas jika tatalaksana non-operatif akan berhasil atau tidak dan membutuhkan tatalaksana secara operatif. 13,14 Setelah selesai serial cast, dibutuhkan follow-up dengan pemeriksaan radiologik kaki untuk melihat hasil koreksi. Jika koreksi telah dicapai, maka dilakukan pemasangan tipe ortosis abduksi Dennis-Brown (Gambar 2).…”

Section: Skor Kontraktur Kaki Bagian Tengahunclassified

“…Namun, jika pada follow-up belum terlihat perubahan bermakna, maka perlu dilakukan tenotomi tendon Achilles pada usia 6 sampai 12 bulan setelah lahir. 13 Gambar 2. Metode Ponseti dan Foot Abduction Brace (FAB) tipe Dennis-Brown.…”

Section: Skor Kontraktur Kaki Bagian Tengahunclassified

“…Metode PMR merupakan tindakan operasi yang dilakukan pada kasuskasus CTEV yang tidak terkoreksi atau relaps saat pasien sudah bisa berjalan. 13,16 Setelah koreksi operatif berhasil dicapai, dilanjutkan dengan pemasangan 3 K-wires, dengan mentransfiksasi pertama sendi kalkaneokuboid, dilanjutkan dengan talonavikular kemudian pergelangan kaki. Kemudian dilakukan penjahitan tendon Achilles dan tendon tibial posterior.…”

Section: Kaki Normal Kaki Terkenaunclassified

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Congenital Talipes Equinovarus (CTEV)

Laloan¹,

Lengkong²

2020

eCL

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Congenital talipes equinovarus (CTEV) is a type of foot deformities characterized with hindfoot varus, adducted metatarsus, wide arched of the foot (cavus), and equinus. Its incidence is 1.2% per 1000 births annually. Around 80% of cases occur as idiopathic type and the remaining 20% is associated with other anomaly conditions. Genetic component is considered to play a role in the occurrence of CTEV. However, up to this day, there is no exact underlying etiology that defines the exact pathogenesis of CTEV. The evolving etiology nowadays is still multifactorial. Management of CTEV varies from non-surgical treatment to surgical treatment. A number of scoring and grading using qualitative and quantitative measurement are being used nowadays to assess the severity of CTEV because this deformity needs long-term follow-up due to its tendency to relapse.Keywords: congenital talipes equinovarus, clubfoot Abstrak: Congenital talipes equinovarus (CTEV), dikenal juga dengan true clubfoot, merupakan deformitas pada kaki yang ditandai oleh adanya bentuk varus kaki belakang, adduksi metatarsus, dan adanya bentuk lengkungan kaki yang lebar (cavus) serta equinus. CTEV merupakan salah satu dari deformitas kaki pada saat lahir dengan insidensi 1,2% per 1000 kelahiran hidup per tahunnya. Pada 80% kasus terjadi secara idiopatik dan 20% dikaitkan dengan kondisi-kondisi lain. Komponen genetik diduga berperan pada CTEV, namun, sampai saat ini, belum ada etiologi pasti yang menjelaskan patogenesis CTEV. Etiologi yang berkembang sampai saat ini bersifat multifaktorial. Tatalaksana pasien CTEV bervariasi mulai dari non-operatif maupun operatif. Sejumlah pengukuran kualitatif maupun kuantitatif telah dikembangkan untuk menilai keparahan CTEV berhubung kondisi deformitas ini membutuhkan follow-up jangka panjang karena mempunyai kecenderungan untuk relaps.Kata kunci: congenital talipes equinovarus, clubfoot

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Corrective bandages and daily manipulations for treatment of congenital vertical talus: a thirteen year follow-up

Utrilla-Rodríguez

Díaz-Ávila

Sáez-Díaz³

et al. 2023

International Orthopaedics (SICOT)

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Purpose To analyze the results of a conservative method for treating congenital vertical talus in children with early start and to know in which cases surgical treatment was needed. Methods A retrospective analysis of all children diagnosed with idiopathic vertical talus was carried out during the years 2008–2021. Thirty-two children (46 feet) were finally included. Children were treated with serial manipulations, muscle stimulation, and corrective bandages. Age at the time of initiation of treatment, duration of treatment, and correction or not of the deformity without surgical intervention were recorded as variables of interest. The talocalcaneal angle, TAMBA, and ankle range of motion were measured before treatment, after treatment, and at the end of the follow-up period. Statistics decision tree was used to determine which variable best discriminated whether the patient needed surgery. To complement the tree diagram, a two-step cluster analysis was carried out. Results After treatment, TAMBA and talocalcaneal angle changed from “vertical” to “oblique” category in 45 and 37 feet, respectively. The pathological dorsal flexion of the ankle changed to normal in 37 feet and ankle plantar flexion was normal in 46 feet. These variables showed significant changes between the three measurement moments. The results of the statistics decision tree and cluster analysis indicate that “No surgery” was associated with an age equal to or lower than one week when treatment was started, and with an ankle plantar flexion range of motion lower than 36°. Conclusions The beginning of this conservative treatment in the first week of life and having a plantar flexion of the ankle lower than 36° were related to the success of the treatment without surgery.

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Management of foot deformity in children

Cited by 18 publications

References 26 publications

Naviculectomy for two ambulatory children with intractable congenital vertical talus: redefining the indications of an old technique

Naviculectomy for two ambulatory children with intractable congenital vertical talus: redefining the indications of an old technique

Congenital Talipes Equinovarus (CTEV)

Corrective bandages and daily manipulations for treatment of congenital vertical talus: a thirteen year follow-up

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