Osteopathic manipulative treatment of congenital talipes equinovarus: A case report (original) (raw)
Related papers
Journal of Research in Orthopedic Science, 2022
Background: Congenital talipes equinovarus (CTEV) is a prevalent congenital foot deformity. The Ponseti method is a non-surgical treatment for clubfoot, which entails a sequence of casts and braces. The accelerated Ponseti method is a modified version of the standard Ponseti method, involving more frequent cast changes. Methods: A total of 60 patients with idiopathic congenital talipes equinovarus (CTEV) under the age of one were carefully chosen and assigned to two groups of A (standard) and B (accelerated). The Pirani score was used to evaluate each clubfoot before applying a cast. In group A, aboveknee casting was performed once a week, while in group B, it was done twice a week. Results: The study involved 60 children with a total of 75 feet. The results indicated a shorter treatment duration with the accelerated Ponseti method, while the occurrence of skin complications was comparable between the two methods. Conclusion: In conclusion, both the accelerated and standard Ponseti methods are equally effective in correcting clubfoot. The accelerated method offers the advantage of reducing the overall treatment duration and has clear benefits, while no notable difference is observed in skin complications between the two methods.
Corrective Surgery in Congenital Talipes Equinovarus Deformity: A Camp Approach
2015
The study was intended to assess the results of soft tissue release and bony corrective surgery in patients of moderate to severe deformed rigid club foot (CTEV) and neglected clubfoot (CTEV) at free disabled surgical camps at Chhattisgarh state. MATERIAL AND METHODS: In our study 50 patients were included with 70% male and 30% female with 4-16 years of age group and 70% unilateral and 30% bilateral foot involvement. Patients were admitted and operated in different free disabled surgical camps at Chhattisgarh state over the period of 36 months (1 may 2004 to 30 th April 2007). Improvement in functional ability and locomotion of all operated patients were assessed by physical and clinical examination. RESULTS: All patients who were operated in our study showed significant improvement in functional ability and locomotion after surgery. All patients were maintaining functional ability at follow up duration of 12 months (1 year). 75% patients were walking normally, 10% cases were walking with internal rotation of leg and 5% cases were walking with midtarsal varus foot with AFO with medial bar support. CONCLUSION: Our study showed and established that excellent results can be obtained in congenital talipes equinovarus (CTEV) patients by soft tissue release with bony corrective surgery. The team work of devoted surgeons, paramedical and rehabilitation staff in whole duration of camps to achieve the goal. With an aim to help more number of CTEV cases by surgery, our team has started doing surgeries in small institutions, and organize charity camps to help poor patients and mankind even in small clinics. INTRODUCTION: The commonly called clubfoot is scientifically called congenital talipes equinovarus has a tendency to show relapse irrespective of the treatment either with conservative management or surgical management, and was described by Hippocrates in 400 BC. Congenital talipes equino varus (CTEV) deformity is most common congenital disability of the foot in our country. (1) In every 1000 birth one child is having CTEV. (2) CTEV may be associated with joint laxity, congenital dislocation of the hip, tibial torsion, ray anomalies of the foot absences of some tarsal bones and a history of other foot anomalies in the family. (3) Of all these bones most relevant for this congenital deformity are the talus, calcaneus and navicular. The calcaneus and navicular are medially rotated in relation to the talus. The foot is held in adduction and inversion by ligaments and muscles. (4) Cases of congenital talipes equino varus are neglected due to illiteracy, poverty, ignorance and lack of proper health services especially in villages. A disabled person in the family becomes nonearning and seems to be burden to family unless rehabilitated. Conservative management plays vital role and becomes useful if reported early. Ponseti technique
Operative Result of Resistant Congenital Talipes Equinovarus Cases: Our Experience
Journal of evolution of medical and dental sciences, 2016
Congenital Talipes Equinovarus is the most common foot deformity and its incidence is approximately one in 1000 live births. 1 Congenital talipes equinovarus is a complex deformity and has a tendency to recur until the age of six or seven years. 2 Treatment varies from non-operative method 3 to a variety of surgical techniques. 4 AIM This study aims to assess the results of operative treatment in CTEV cases. It is our humble hope that this work would throw some light on this demanding, resource consuming problems and management in our setup and with our scarce resources. MATERIALS Thirty six patients with sixty deformed feet were taken for one stage posterior medical soft tissue release who were admitted in the
Outcomes of Congenital Talipes Equinovarus Treated with Ponseti Method
International Journal of Contemporary Medical Research [IJCMR], 2019
Idiopathic clubfoot or congenital talipes equinovarus is characterized by an excessively turned-in foot and a high medial longitudinal arch is the commonest congenital foot deformities having 1 in every 1000 children born worldwide. Though described long back, there has been an interest towards Ponseti method of conservative treatment of clubfoot recently. Our study was aimed to assess the efficacy of Ponseti technique in correcting congenital talipes equinovarus deformity of foot. Material and methods: 65 patients were enrolled in the study out of which 47 patients were available for final follow-up. All patients presenting with CTEV with age up to 2 years were included and patients more than 2 years, operated cases and syndromic clubfoot were excluded. We treated all patients with Ponseti method of serial casting and tenotomy. results: Out of the total 65 feet studied, 42 feet (64.62%) required tendo achilles tenotomy and 23 feet (35.38%) were treated with casting alone and tenotomy was not required. In our study, there were 8 cases of relapes (12.31%).Out of these, 7 were idiopathic and 1 was syndromic. Out of these 8 relapses, 2 required repeat tenotomy and 6 were treated with casting as per ponseti technique. Complications due to plaster were minimal in our study. Incidence of rocker bottom feet in our study is nil because of dedicated clubfoot manipulation in clubfoot clinic and patients were followed up regularly. Conclusion: To conclude, this study showed that clubfoot deformity can be managed successfully provided the technique and details of manipulation described by Ponseti are followed strictly and patients can be followed up regularly by a team of dedicated orthopedic surgeons.
Management of Congenital Talipes Equinovarus by Ponseti Technique: A Clinical Study
Journal of Foot & Ankle Surgery, 2008
The purpose of this study was to evaluate the early results of treatment of idiopathic congenital talipes equinovarus (CTEV) by the Ponseti method and compare the results with those of other manipulation techniques and surgical treatment reported in the literature. A total of 100 patients with 156 clubfeet (80 males, 20 females), were treated for idiopathic CTEV by the Ponseti method. The average age at presentation was 4.5 months. Scoring of each foot was done according to the Pirani score. Photographs showing the deformity and podograms were taken to have an objective record against which the results were compared. The mean total Pirani score at the start of treatment was 4.26 and mean foot print angle (FPA) was 14.2°. Post correction, there was a significant difference (P Ͻ .001, z ϭ 18.638) in the mean FPA. There was also a statistically significant difference between the pre-and postcorrection Pirani scores (P Ͻ .001, z ϭ 55.427). In 95% of the patients correction of the deformity was achieved. The Ponseti technique is based on sound understanding of the pathoanatomy of clubfoot. The good results obtained by the Ponseti technique show that posteromedial soft tissue release may no longer be required for most cases of idiopathic CTEV.
Children (Basel, Switzerland), 2018
Congenital talipes equinovarus (CTEV), also known as clubfoot, is a complex congenital deformity of the foot that, left untreated, can limit a person's mobility by making it difficult and painful to walk. Worldwide, 80% of children born with clubfoot are in low- and middle-income countries. The management of clubfoot has a long history. Non-operative management did not become popular, as an increasing number of orthopaedists started leaning towards surgical treatment. The late Dr. Ignacio Ponseti developed a method of clubfoot correction that successfully realigns clubfoot in infants without extensive and major surgery. The aim of the study was to assess the functional outcome of CTEV management by the Ponseti technique, to study the severity of CTEV deformity using the Pirani score, and to evaluate the cost-effectiveness of the technique. A total of 356 cases with 402 feet with CTEV were treated by the Ponseti method. The average age of the children and the number of casts appl...
Journal of Orthopaedics and Traumatology, 2015
Background We reviewed a series of newborns, toddlers and ambulating children affected by idiopathic congenital talipes equinovarus (clubfoot). Taking into account the time of diagnosis, stiffness of the deformity and walking age, nonsurgical or surgical treatment was considered. This study reports clinical outcomes, early complications and relapse at mid-term follow-up. Materials and methods Fifty-two clubfeet were diagnosed at birth, 12 in non-ambulating children aged between 4 and 12 months and 24 in ambulating children. Feet were classified using the Pirani score. Newborns and toddlers were treated with serial casting (Ponseti); however, toddlers also underwent open Achilles tendon lengthening (2 feet) and posteromedial release (3 feet). In all ambulating children, surgical treatment was always performed: selective medial release combined with cuboid subtraction osteotomy (1 foot), posteromedial release (6 feet), and posteromedial release combined with cuboid subtraction osteotomy (17 feet). Results The average follow-up was 5 years (1-6 years). In newborns treated with Ponseti, the results were excellent in 42 feet, good in 6, and poor in 4. In non-ambulating children, the results were excellent in 9 feet, and good in 3. In ambulating children, the results were excellent in 5 feet, good in 16, and poor in 3. No major complications were reported. No overcorrections were observed. The need for open surgery was higher in cases of delayed treatment. In cases of relapse, re-casting and/or more extensive surgery was considered. Conclusions Early treatment enables a high rate of good correction to be obtained with serial casting and limited surgery. Conversely, if the deformity is observed after walking age surgery should be considered. Serial casting in cases of late observation and relapse have demonstrated encouraging results. Level of evidence IV.
Egyptian Journal of Orthopedic Research, 2021
Congenital talipes equinovarus (clubfoot) is one of the most common congenital anomalies encountered in pediatric orthopedics. Its incidence is about 1:1000 live births. It remains a challenge not only to understand its genetic origins but also to provide effective long-term treatment and prevention of recurrences. Clubfoot can lead to serious walking problems if left untreated. Conservative treatment with the Ponseti method has revolutionized the clubfoot treatment and has been adopted globally in the last decades. Surgical treatment is indicated only after failure of conservative methods. Surgical release rate of the idiopathic clubfoot has decreased significantly since the emergence of the Ponseti method. The aim of this study was the evaluation of using ponseti technique for correction of cases of idiopathic CTEV deformity by clinical and radiological follow up aiming at determining benefits, drawbacks and obstacles to this technique . Between March 2020 and March 2021, total of...
Background: Treatment of idiopathic congenital talipes equinovarus (CTEV) is challenging for pediatric orthopedic surgeons. The Ponseti method is an effective protocol for treatment due to its technique of manipulation, casting, and limited surgery. Plaster casting is an essential component of the Ponseti method. In this report, we describe a new brace that was developed for use in the treatment of clubfoot in newborns instead of a plaster cast.