Early results of a new method of treatment for idiopathic congenital vertical talus (original) (raw)
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Journal of Children's Orthopaedics, 2012
Introduction The traditional treatment for congenital vertical talus, which involves serial casting and extensive soft-tissue releases, has been associated with severe stiffness and other complications in adolescents and adults. Our hypothesis is that favorable results will be obtained using the Dobbs method of serial manipulation, casting, and limited surgery for vertical talus correction, even in older children and syndromic cases. Therefore, the present study aimed at evaluating the Dobbs method in such cases. Materials and methods We treated 15 feet of 10 patients (aged from 1 month to 9 years) using manipulation and serial casting or the reverse Ponseti method followed by percutaneous Achilles tenotomy and limited open reduction of the talonavicular joint. All patients were evaluated both clinically and radiologically in a mean follow-up period of 2 years. Results After 2 years, all patients had plantigrade and flexible feet with good radiographic correction. The mean talocalcaneal angle before (70.5°± 10.5) and after (31°± 5.2) treatment and the talar axis metatarsal base angle before (60°± 11.4) and after (15°± 6.7) treatment were significantly improved (P \ 0.001).
Sudanese journal of paediatrics, 2019
Club foot or congenital talipes equinovarus (CTEV) is a common developmental disorder of the foot, affecting 1 per 1,000 live births. The main goal of this study is to evaluate the anatomical bony arrangement of the clubfoot deformity radiologically and to correlate this arrangement with the Pirani clinical scoring system. This descriptive, analytical study was conducted in three centres in Sudan. It recruited all the patients of both sexes with CTEV attending these centres, and excluding children on conservative cast and those who already had surgery. Data were collected using structured questionnaire. Pirani clinical scoring system, a reliable clinical assessment method, was applied. Four angles were used to measure each component of the deformity and correlate this with the Pirani score. Feet radiology was performed to assess the bone anatomy. The index cases number was 25 with male-to-female ratio of 1.6:1. Both feet were involved simultaneously in about half of the cases. Only ...
Medical and Health Science Journal, 2011
The evaluation of clubfoot should be undertaken mainly on the clinical basis because many studies have shown no consistent relationship between radiographic appearance and the functional outcome in the evaluation of clubfoot. Foot bimalleolar angle (FBM) is a simple, objective and reproducible criterion that can be used to evaluate the results of treatment. This study was done to establish the normal FBM angle on foot tracing of normal Jordanian population, to calculate FBM angle in resistant congenital talipes equinovarus (CTEV) before and after surgery and to correlate it with the clinical results. The FBM angle of 200 feet in 100 normal infants (50 male and 50 female) ranging in age from 1 month to 12 months was determined. In a 15 year period (1988)(1989)(1990)(1991)(1992)(1993)(1994)(1995)(1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003), 102 (72 male, 30 female) out of 215 patients with resistant clubfeet who were treated surgically in Princess Basma Teaching Hospital and King Abdullah University Hospital (KAUH), Irbid-Jordan, were available at the final follow up visit. The patients were divided according to the type of surgical correction into 2 groups: the first group consisting of 60 patients (75 clubfeet) were treated by complete subtalar release as described by Simons. The second group consisting of 42 patients (50 clubfeet) were treated by Turco posteromedial release. At the latest follow up FBM angle for the 2 groups was determined. Clinical evaluation of the 2 groups correlated well with FBM angle.
2021
Introduction: Foot length (FL) and width (FW) were measured in unilateral idiopathic congenital talipes equinovarus (CTEV) treated via the Ponseti method and difference was compared in foot sizes, if any. Material and methods: Total 30 patients were enrolled in study, comparing FL and FW in affected vs unaffected in unilateral clubfeet and analyzed statistically. Results: The mean FL for affected foot was 11.2433 cm and 11.8380 cm for unaffected foot. The mean FW for affected foot was 5.5433 cm and 5.5867 cm for unaffected foot. The difference between the FL and FW was assessed by the paired t test. The mean FL difference between the affected and unaffected foot was found to be 0.05600 and a p value of 0.716 was found to be statistically insignificant. Likewise, the mean FW difference was found to be 0.0233 and a p value of 0.742 was also statistically insignificant. Both the size difference was statistically insignificant and was comparable to each other. Conclusion: Foot length and FW between the affected and the unaffected foot are comparable to each other and the mean difference between these two is statistically insignificant.
Subjective and objective outcome in congenital clubfoot; a comparative study of 204 children
BMC Musculoskeletal Disorders, 2007
Background Outcome following management of congenital talipes equinovarus (clubfoot) can be assessed in a number of ways. Bjonness stated simply that "the patient is the final judge of whether he has a good foot"; a purely subjective assessment. Others have employed objective measures. Combining subjective evaluation with a more objective assessment of movement and position of the foot, is likely to give a more comprehensive picture of the final result of clubfoot. The purpose of this study was to compare subjective and objective outcome following management of clubfoot, and evaluate sex differences in outcome. Methods We used a patient-administered subjective assessment of outcome following treatment of clubfoot and compared it with objective anthropometry and range of movement of the ankle to assess and compare subjective and objective outcome in clubfoot. Statistical analysis was performed using Pearson correlation coefficients. Significance was tested using Student's t-test test. Results Objective outcome can be assessed using length of the foot, calf circumference and range of movement at the ankle. These are easy to measure, reproducible, and correlate well with subjective outcome. Objective outcome is comparable for boys and girls. However, subjectively, female patients and their parents are less happy with the results of management of clubfoot. Conclusion There is a correlation between the anthropometric measures and the subjective outcome and an objective grading can be designed using foot length, calf muscle bulk and range of movement at the ankle.
Variation in the size of foot and great toe in unilateral CTEV (club foot deformity)
IP Innovative Publication Pvt. Ltd, 2019
Introduction: Congenital Talipes Equinovarus (CTEV) is one of the common foot deformities seen in new born. It has prevalence of 1 in 1000 population with male preponderance. There is lot of anatomical and functional differences between the effected foot and the normal foot. These differences include variation in size of foot, size of toes, altered vasculature of foot, muscle imbalance between the everters and invertors of foot. These differences can easily be made out if it’s a unilateral deformity as the control for comparison will be the normal foot. Materials and Methods: Present study was done at our institute with coordination with department of orthopedics, including 20 patients with unilateral CTEV. The size of the foot and toes measured after full correction of the deformity. Results: It was found that there is constant decrease in the size of effected foot which is obvious on measurement and there is considerable clinical shortening of the great toe in comparison with the second toe in Club feet. Conclusion: The results obtained in present study will help the orthopedic surgeon to look into the matter of size of foot in future as the child grows and its cosmetic and functional impact over the activity of the subject.