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Journal articles on the topic 'Idiopathic clubfoot'

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Author: Grafiati

Published: 10 December 2022

Last updated: 28 January 2023

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1

van Bosse, H. J. P. "Challenging clubfeet: the arthrogrypotic clubfoot and the complex clubfoot." Journal of Children's Orthopaedics 13, no. 3 (June 2019): 271–81. http://dx.doi.org/10.1302/1863-2548.13.190072.

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Within the realm of clubfoot deformities, teratologic and complex (or atypical) clubfeet stand out as the most difficult. Exemplarities of the teratologic types of clubfoot are those associated with arthrogryposis multiplex congenita. Treatment of arthrogrypotic clubfoot deformities has been controversial; many different procedures have been advocated, with variable success rates. These clubfeet have a high recurrence rate, regardless of treatment type. Often, the high recurrence rate has led to a high repeat surgery rate, and poor outcomes. Treatment strategies should highlight care that avoids the development of a stiffened foot and allows for a variety of options to regain correction when a relapse occurs. Modifications of the Ponseti method for idiopathic clubfeet have been successful in managing the deformity. The equinocavus variant of the arthrogrypotic clubfoot should be distinguished from the classic clubfoot, as it requires a different treatment method. The equinocavus clubfoot is very similar to the complex or atypical clubfoot. The complex, or atypical, clubfoot also requires a different treatment strategy compared with the typical idiopathic congenital clubfoot. The complex clubfoot appears to be idiopathic in some cases and iatrogenic (due to slipping stretching casts) in others. Dr. Ponseti’s modification of his protocol has been effective in treating the deformity. The high recurrence rate suggests the difficulty in maintaining the deformity after correction. The author’s preferred treatment for each deformity is included, with an emphasis on minimally invasive methods. Level of Evidence Level V, expert opinion

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Wimberly, Robert Lane. "Idiopathic clubfoot." Current Opinion in Orthopaedics 16, no. 6 (December 2005): 451–56. http://dx.doi.org/10.1097/01.bco.0000181536.34897.1b.

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Ahmad, Shafiq, Shakeel Ahmed, Mahreen Zahra, Amir Hanif, Bilal Hussain, and Muhammad Kashif. "Management of Spina Bifida Related Non Idiopathic Club-Foot with Ponseti's Method." Pakistan Journal of Medical and Health Sciences 16, no. 5 (May 26, 2022): 278–80. http://dx.doi.org/10.53350/pjmhs22165278.

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Objective: To determine the outcome of Ponseti’s method among children with spina bifida related non-idiopathic clubfoot at a leading pediatric tertiary care children hospital of South Punjab, Pakistan. Study Design: A retrospective cohort. Place and Duration of the Study:Department of Pediatric Orthopedic Surgery, The Children’s Hospital and Institute of Child Health, Multan Pakistan from 1st January 2016 to 31st March 2022. Material and Methods: A total of 24 children (41 feet)of both genders aged up to 3 months presenting with non-idiopathic clubfoot related to spina bifida who underwent Ponseti’s method for treatment of clubfoot, with a minimum post-treatment follow up of 3 years were included. Demographic data, severity of clubfoot disease along outcomes in terms of successful correction, unsuccessful correction, relapse were noted during the study period. Results: In a total of 24 children, 15 (62.5%) were boys. Overall, mean age was calculated to be 2.6±2.2 weeks while 14 (58.3%) children were aged between 0-2 weeks. Bilateral feet were involved in 17 (70.8%) children while unilateral feet involvement was noted in 7 (29.2%) cases so total number of feet were 41. Out of these 41 feet, 38 (92.7%) had severity of clubfoot as per Pirani Score as 6. Number of casts performed were 8 or below in 39 (95.1%). Mean duration of follow up was 3.8±0.6 years. Correction of clubfoot was achieved in 36/41 (87.8%) feet. During the follow-ups, recurrence occurred in 11 (26.8%) feet. Conclusion:Initial clubfeet correction in the spina bifida cases achieved good correction rates. Rate of recurrence was considerably high with a minimum follow up period of 3 years among spina bifida associated clubfeet. Keywords: Achilles tendon, clubfoot, Pensoti’s method, spina bifida.

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Bhatiwal, Sunil Kumar, B. L. Chopra, B. L. Khajotia, and Shakti Chauhan. "Idiopathic clubfoot treated by Ponseti method: a series of 300 cases." International Journal of Research in Orthopaedics 4, no. 6 (October 24, 2018): 954. http://dx.doi.org/10.18203/issn.2455-4510.intjresorthop20184383.

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<p class="abstract"><strong>Background:</strong> Clubfoot is a complicated deformity of the foot. It is one of the commonest congenital deformities in children. The main aim of this study was to evaluate the efficacy management of clubfoot by Ponseti method.</p><p class="abstract"><strong>Methods:</strong> This prospective study included 300 children (456 club feet) below the age of 2 years with idiopathic clubfeet from January 2013 to December 2017. In all the cases the Ponseti method was used for the management. The severity of the deformity was assessed with the help of the Pirani score and clinical evaluation of the foot was done.<strong></strong></p><p class="abstract"><strong>Results:</strong> Out of 300 patients 204 patients were male and 96 patients were female and 144 were unilateral clubfoot and 156 were bilateral cases of clubfoot. The mean number of casts required for correction was 5.4 (4–10). Out of 456 clubfeet 356 (78%) feet were required tenotomy. There was relapse seen in 36 (7.9%) feet which had to be managed with 2–3 serial manipulations and casting and these resolved. Excellent result found in our study in 92% cases, good results were found in 5% cases and poor results were found in 3% cases.</p><p class="abstract"><strong>Conclusions:</strong> Ponseti technique is a very useful and effective method of management of idiopathic clubfoot up to 2 year of age.</p>

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Selmani, Edvin, Julian Ruci, and Arben Gjonej. "Percutaneous Achilles Tenotomy in Idiopathic Clubfoot treatment." Albanian Journal of Trauma and Emergency Surgery 7, no. 1 (January 20, 2023): 1104–6. http://dx.doi.org/10.32391/ajtes.v7i1.301.

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Introduction; Percutaneous Achilles tenotomy is a standard procedure in most clubfoot patients treated with Ponseti method as the most widely use method of conservative clubfoot treatment. To our knowledge, there are not studies published in Albanian literature about this technique. Our goal is to present results of conservative treatment of idiopathic clubfoot where this technique was performed. Material and Method. This is a prospective study of all idiopathic clubfoot patients treated in our Institution with Ponseti Method. We performed this technique under sedation anesthesia in operation room, not in clinic. We measured age of patient at time of presentation, gravity according to Pirani score, number of casting, need for Achilles tenotomy). We measured the degree of angle of dorsiflexion before and after this procedure, the gravity and need for a second procedure. Results: Out 400 clubfeet treated during 2005-2010 we included in our study 372 case that needed the percutaneous Achilles tenotomy performed. Average age at presentation was 3 weeks. Average Pirani score was 5.5. The number of weekly serial cast needed before the tenotomy was 8. Dorsiflexion angle after this procedure was improved by 45 degree (range from 30 to 90 degree). Only 2 cases needed reoperation due to non-compliance with foot abduction bar and physiotherapy Conclusion: The percutaneous Achilles tenotomy is used in 93% of case with idiopathic clubfoot serie of patient. It is an easy technique performed with sedation anesthesia in operation room not with local anesthesia. Achilles tenotomy is an important element to avoid recurrence This supports other studies that have used this method.

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Kyzer, Susan P. "Congenital Idiopathic Clubfoot." Orthopaedic Nursing 10, no. 4 (July 1991): 11–18. http://dx.doi.org/10.1097/00006416-199107000-00004.

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Alexander, Maryann, Jeffrey D. Ackman, and Ken N. Kuo. "Congenital Idiopathic Clubfoot." Orthopaedic Nursing 18, no. 4 (July 1999): 47???58. http://dx.doi.org/10.1097/00006416-199907000-00014.

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Portalatin, Edwin, Sarah Parenti, Jordan L. Polk, Chan-Hee Jo, Jacob R. Zide, and Anthony Riccio. "The Ponseti Method for the Treatment of Clubfeet Associated with Down Syndrome." Foot & Ankle Orthopaedics 7, no. 4 (October 2022): 2473011421S0088. http://dx.doi.org/10.1177/2473011421s00884.

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Category: Other Introduction/Purpose: This study aims to compare treatment characteristics and outcomes of clubfoot patients with Down Syndrome (DS) to those with idiopathic clubfoot treated with the Ponseti method. Methods: A retrospective review of prospectively gathered data was performed at a single institution over an 18-year period. Patients with idiopathic clubfeet (IC) and clubfeet associated with DS who were less than one-year old and treated by the Ponseti method were included. Initial Dimeglio score, number of casts, need for tendoachilles tenotomy, recurrence, and need for further surgery were recorded. Outcomes were classified using the Richards classification system. Results: 24 clubfeet in 15 patients with DS, and 320 IC in 225 patients were identified with an average follow-up of 62 and 65 months respectively. DS patients presented for treatment at an older age (54 vs. 16 days, p=0.000) and with lower initial Dimeglio scores (11.1 vs. 13.7, p=0.000). Tendoachilles tenotomy was performed in 79% of IC and 75% of the DS clubfeet (p=0.64). Recurrence rates were not statistically different between the groups, nor was the need for later surgery. However, recurrences in the DS group were significantly less likely to require intra-articular surgery (4.2% vs. 34.4%, p=0.02). Clinical outcomes were 83% 'good', 13% 'fair', and 4% 'poor' in DS patients, and 69% 'good', 27% 'fair', and 4% 'poor' in the idiopathic cohort (p=0.1). Conclusion: Despite milder deformity and older age at presentation, DS associated clubfeet have similar recurrence rates and clinical outcomes as their idiopathic counterparts. When deformities do relapse in DS patients, significantly less intra-articular surgery is required than for idiopathic clubfeet.

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Redah, Samer Mohammed. "Complications of Ponseti Technique in Treatment of Idiopathic Club Foot." AL-Kindy College Medical Journal 18, no. 2 (August 31, 2022): 123–26. http://dx.doi.org/10.47723/kcmj.v18i2.776.

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Background: Clubfoot, or talipes equinovarus, is a congenital deformity that consist of; supination and adduction of the forefoot and midfoot; equinus of hindfoot and varus. It was found that more than 100,000 babies are born each year with congenital clubfoot Objectives: The purpose of this study was to investigate the complications of ponseti method for treatment of children with idiopathic club foot. Subjects and Methods: 50 children with 74 clubfeet were managed by Ponseti method from May 2019 to July 2020 in Al-Wasity teaching hospital with primary correction of the deformity followed sometimes by elongation of Achilles tendon then the patients were followed up till June 2021 and the complications were calculated. Results: complications were 10.8% incomplete correction (mostly equinus) and it was corrected by surgery, 6.7% ulcer on the medial surface of head of 1st metatarsal , 9.4% cast falling and 18.9% relapse. Conclusions: Ponseti technique is a safe and effective method for correction of clubfoot and decreases the need for corrective surgery with minimal complications that can be easily managed.

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Loza, Michel Eshak, Sherif NG Bishay, Hassan Magdy El-Barbary, Atef Abdel-Aziz Zaki Hanna, Yehia Nour El-Din Tarraf, and Ashraf Adel Ibrahim Lotfy. "Double column osteotomy for correction of residual adduction deformity in idiopathic clubfoot." Annals of The Royal College of Surgeons of England 92, no. 8 (November 2010): 673–79. http://dx.doi.org/10.1308/003588410x12699663904718.

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INTRODUCTION Adduction of the forefoot is the most common residual deformity in idiopathic clubfoot. The ‘bean-shaped foot’, which is a term used to describe a clinical deformity of forefoot adduction and midfoot supination, is not uncommonly seen in resistant clubfoot. SUBJECTS AND METHODS Fifteen children (20 feet) with residual forefoot adduction in idiopathic clubfeet aged 3–7 years were analyzed clinically and radiographically. All of the cases were treated by double column osteotomy (closing wedge cuboid osteotomy and opening wedge medial cuneiform osteotomy) with soft tissue releases (plantar fasciotomy and abductor hallucis release), to correct adduction, supination and cavus deformities. Pre-operative measurements of certain foot angles were compared with their corresponding postoperative values. RESULTS A grading system for evaluation of the results using a point scoring system was suggested to evaluate accurately both clinical and radiographic results after a follow-up period of an average of 2.3 years. Eight feet (40%) had excellent, eight (40%) good, three (15%) fair, and one (5%) poor outcome. There was no major complication. There was significant improvement in the result (P > 0.04). CONCLUSIONS Double column osteotomy can be considered superior to other types of bone surgeries in correction of residual adduction, cavus and rotational deformities in idiopathic clubfoot.

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Sanghvi, AV, and VK Mittal. "Conservative Management of Idiopathic Clubfoot: Kite versus Ponseti Method." Journal of Orthopaedic Surgery 17, no. 1 (April 2009): 67–71. http://dx.doi.org/10.1177/230949900901700115.

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Purpose. To compare the long-term results of the Kite and Ponseti methods of manipulation and casting for clubfoot. Methods. 42 patients (with 64 idiopathic clubfeet) were equally randomised to Kite or Ponseti treatments in the early weeks of life. 14 males and 7 females (34 clubfeet) were treated by the Kite method, whereas 13 males and 8 females (30 clubfeet) were treated by the Ponseti method. All the clubfeet were manipulated, casted, and followed up (for a mean of 3 years) by one experienced orthopaedic surgeon. The final results were compared. Results. The success rates for the Kite and Ponseti treatments were similar (79% vs 87%). With the Ponseti method, the number of casts was significantly fewer (7 vs 10); the duration of casting required to achieve full correction was significantly shorter (10 vs 13 weeks); the maximum ankle dorsiflexion achieved was significantly greater (12 vs 6 degrees); and the incidence of residual deformity and recurrence was slightly lower. Conclusion. The Ponseti method can achieve more rapid correction and ankle dorsiflexion with fewer casts, without weakening the Achilles tendon.

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Zionts, Lewis E., Nathan Frost, Rachel Kim, Edward Ebramzadeh, and Sophia N. Sangiorgio. "Treatment of Idiopathic Clubfoot." Journal of Pediatric Orthopaedics 32, no. 7 (2012): 706–13. http://dx.doi.org/10.1097/bpo.0b013e3182694f4d.

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DePuy, Jim, and James C. Drennan. "Correction of Idiopathic Clubfoot." Journal of Pediatric Orthopaedics 9, no. 1 (January 1989): 44–48. http://dx.doi.org/10.1097/01241398-198901000-00009.

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Kyzer, Susan P., and Sharon Lee Stark. "Congenital Idiopathic Clubfoot Deformities." AORN Journal 61, no. 3 (March 1995): 491–506. http://dx.doi.org/10.1016/s0001-2092(06)63739-3.

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Carney, Brian T., and Tonya R. Coburn. "Demographics of Idiopathic Clubfoot." Journal of Pediatric Orthopaedics 25, no. 3 (May 2005): 351–52. http://dx.doi.org/10.1097/01.bpo.0000152943.02864.1a.

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Lascombes, P., D. A. Popkov, and S. S. Leonchuk. "Reconstructive surgery in recurrent deformity (clubfoot relapse)." Genij Ortopedii 27, no. 4 (August 2021): 435–40. http://dx.doi.org/10.18019/1028-4427-2021-27-4-435-440.

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Introduction Recurrent clubfoot deformity may be due to either an imperfect initial correction, or a natural history of a severe disease. In the later, idiopathic clubfoot is uncommon. In the review we describe reconstructive surgery in recurrent deformity of idiopathic clubfoot. Material and methods Surgery may be justified at different age and according to the type of deformity. Different surgical approaches and their indications are exposed in the article. Results After Ponseti’s method application additional surgeries may be considered in recurrent clubfoot deformity which may represent 10 to 20 % of cases: second Achilles tenotomy, postero-lateral relapse, complete antero-medial and postero-lateral relapse, transfer of the anterior tibial tendon, correction of sequelae: metatarsus varus, residual equinus, residual rotation of the calcaneopedal unit. Conclusion Idiopathic equine varus clubfoot is a frequent condition. Well-codified management should lead to extremely favorable functional results. Unfortunately, some cases lead to a recurrence of the deformity. Surgical procedures are sometimes required. The goal is to avoid as much as possible arthrodesis and secondary degenerative arthritis.

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Youn, Sean B., Ashish S. Ranade, Anil Agarwal, and Mohan V. Belthur. "Common Errors in the Management of Idiopathic Clubfeet Using the Ponseti Method: A Review of the Literature." Children 10, no. 1 (January 12, 2023): 152. http://dx.doi.org/10.3390/children10010152.

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Congenital talipes equinovarus is one of the most prevalent birth defects, affecting approximately 0.6 to 1.5 children per 1000 live births. Currently, the Ponseti method is the gold-standard treatment for idiopathic clubfeet, with good results reported globally. This literature review focuses on common errors encountered during different stages of the management of idiopathic clubfeet, namely diagnosis, manipulation, serial casting, Achilles tenotomy, and bracing. The purpose is to update clinicians and provide broad guidelines that can be followed to avoid and manage these errors to optimize short- and long-term outcomes of treatment of idiopathic clubfeet using the Ponseti method. A literature search was performed using the following keywords: “Idiopathic Clubfoot” (All Fields) AND “Management” OR “Outcomes” (All Fields). Databases searched included PubMed, EMBASE, Cochrane Library, Google Scholar, and SCOPUS (age range: 0–12 months). A full-text review of these articles was then performed looking for “complications” or “errors” reported during the treatment process. A total of 61 articles were included in the final review: 28 from PubMed, 8 from EMBASE, 17 from Google Scholar, 2 from Cochrane Library, and 6 from SCOPUS. We then grouped the errors encountered during the treatment process under the different stages of the treatment protocol (diagnosis, manipulation and casting, tenotomy, and bracing) to facilitate discussion and highlight solutions. While the Ponseti method is currently the gold standard in clubfoot treatment, its precise and intensive nature can present clinicians, health care providers, and patients with potential problems if proper diligence and attention to detail is lacking. The purpose of this paper is to highlight common mistakes made throughout the Ponseti treatment protocol from diagnosis to bracing to optimize care for these patients.

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Agarwal, Anil, Nargesh Agrawal, Sitanshu Barik, and Neeraj Gupta. "Are bilateral idiopathic clubfeet more severe than unilateral feet? A severity and treatment analysis." Journal of Orthopaedic Surgery 26, no. 2 (May 1, 2018): 230949901877236. http://dx.doi.org/10.1177/2309499018772364.

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Introduction: Evidences suggest that different subgroups of idiopathic clubfoot exist with differences in severity and treatment outcomes. This study compares the severity and treatment outcomes of unilateral and bilateral clubfoot. Material and methods: We retrospectively studied 161 patients (bilateral 66, unilateral 95) with primary idiopathic clubfeet to evaluate the differences in severity and treatment. The parameters analyzed were precasting Pirani score, number of casts required, pretenotomy Pirani score, pretenotomy dorsiflexion, rate of tenotomy, and post-tenotomy dorsiflexion achieved. A Pirani score of at least 5 was classified as very severe and 4.5 or less was classified as less severe. Results: There were 49=(74.24%) male and 17 (25.75%) female patients in the bilateral group and 76 (80%) male and 19 (20%) female patients in the unilateral group. Out of 95 unilateral patients, 34 were left sided (35.8%). Comparing severity, the mean precasting Pirani score in bilateral patients (5.4 ± 0.6) was statistically more than the unilateral patients (4.9 ± 0.7). The number of casts required was significantly more in bilateral feet compared to unilateral (bilateral 5.3 ± 1.7, unilateral 4.7 ± 1.7; p < 0.011). Achilles tenotomy was required in all feet. Post Ponseti treatment, the foot deformity correction achieved (pretenotomy Pirani score, pretenotomy, and post-tenotomy dorsiflexion) was statistically similar in both unilateral and bilateral feet. Conclusions: Idiopathic bilateral clubfoot was more severe than unilateral foot at initial presentation and required more number of corrective casts. Post Ponseti treatment, the deformity correction in bilateral foot was similar to unilateral foot.

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Divovich, G. V. "Rational selection of treatment methods in recurrent clubfoot." Health and Ecology Issues, no. 3 (October 1, 2021): 64–71. http://dx.doi.org/10.51523/2708-6011.2021-18-3-8.

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Objective. Based on an analytical assessment of the results of surgical treatment of children with equinovarus foot deformity of various origins (idiopathic clubfoot, syndromic clubfoot), to determine a way of rational selection of surgical techniquesin each specifc case.Materials and methods. The results of the treatment of 78 children with congenital idiopathic clubfoot over the period 2010–2018 were assessed in comparison with the results of the treatment of 41 children with recurrent congenital clubfoot, whose primary treatment had been carried out before 2010. We have gained the experience in treating 30 children with severe clubfoot syndrome (meningomyelocele, CNS lesions, chromosomal diseases and others).Results. In the treatment of congenital clubfoot with the Ponseti method, recurrences occur in 21.79 % of the cases, and in the traditional treatment — in 57.74 %. The Ponseti surgical treatment of recurrences consists in performing release operations on the tendon-ligament apparatus from mini-accesses. Cases of rigid, long-standing deformities require extensive releases on soft tissues, as well as resection and arthrodesis interventions on the joints of the foot. The treatment of clubfoot syndrome requires “surgically aggressive” methods of correction in early childhood.Conclusion. In the idiopathic variants of clubfoot and its relapses, it is possible to correct the vicious position of the feet by minimally invasive operations with minimal damage to the tissues of the circumﬂex joints and without damage to the ﬂexor tendons and their sheaths in the medial ankle area. Long-standing recurrent rigid variants, as well as syndromic clubfoot, presuppose the performance of extensive releases, osteotomies and arthrodetic resections of the joints of the foot at an early age. A promising direction for clubfoot correction in the process of child development is a surgery with the use of the bone growth potential of the lower leg and foot.

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Feng, Yixuan, Aaron Bishop, Daniel Farley, Joseph Mitchell, Kenneth Noonan, Xiaoping Qian, and Heidi-Lynn Ploeg. "Statistical shape modelling to analyse the talus in paediatric clubfoot." Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine 235, no. 8 (April 25, 2021): 849–60. http://dx.doi.org/10.1177/09544119211012115.

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One fifth of idiopathic clubfoot deformities cannot be fully corrected by Serial Ponseti casting and deformity recurs in 20%–30% of cases. To avoid x-ray exposure, the joints with largely unossified bones are diagnosed with magnetic resonance images (MRI). Typically, geometric measurements are made in the MRI planes; however, this method is inaccurate compared to measurements on three-dimensional (3D) models of the joint. More accurate measurements using the 3D bone shapes may be better at identifying differences between groups; and therefore, improve diagnosis. The entire set of shape features from MRI can be analysed simultaneously through statistical shape modelling (SSM) which assesses bone morphology of clubfoot in a more sensitive way. A method for SSM of the talus is developed in this study and the shape of the normal talus is compared with the one in clubfeet with residual deformity through both geometric measurements and SSM. Significant differences between two groups were found by both methods; and therefore, might contribute to improve diagnosis of clubfoot.

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Noonan, Kenneth J., and Stephens B. Richards. "Nonsurgical Management of Idiopathic Clubfoot." Journal of the American Academy of Orthopaedic Surgeons 11, no. 6 (November 2003): 392–402. http://dx.doi.org/10.5435/00124635-200311000-00003.

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Rahman, Dr Hafizur, and Dr Siddhartha Rai. "Circumventing tenotomy in idiopathic clubfoot." National Journal of Clinical Orthopaedics 4, no. 2 (April 1, 2020): 147–50. http://dx.doi.org/10.33545/orthor.2020.v4.i2a.221.

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Dewaele, J., B. Zachee, P. De Vleeschauwer, and G. Fabry. "Treatment of the Idiopathic Clubfoot." Journal of Pediatric Orthopaedics B 3, no. 1 (1994): 89–95. http://dx.doi.org/10.1097/01202412-199403010-00016.

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Turco, Vincent J. "Present Management of Idiopathic Clubfoot." Journal of Pediatric Orthopaedics B 3, no. 2 (1994): 149–54. http://dx.doi.org/10.1097/01202412-199403020-00005.

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Mascard, E., M. De la Caffiniere, and R. Seringe. "Conservative Treatment of Idiopathic Clubfoot." Journal of Pediatric Orthopaedics B 6, no. 4 (October 1997): 288. http://dx.doi.org/10.1097/01202412-199710000-00031.

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Dietz, Fred. "The Genetics of Idiopathic Clubfoot." Clinical Orthopaedics and Related Research 401 (August 2002): 39–48. http://dx.doi.org/10.1097/00003086-200208000-00007.

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Imhauser, Gunter, and Dennis R. Wenger. "Idiopathic Clubfoot and Its Treatment." Journal of Pediatric Orthopaedics 7, no. 3 (May 1987): 344. http://dx.doi.org/10.1097/01241398-198705000-00022.

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Ikeda, Kiyoshi. "Conservative Treatment of Idiopathic Clubfoot." Journal of Pediatric Orthopaedics 12, no. 2 (March 1992): 217–23. http://dx.doi.org/10.1097/01241398-199203000-00012.

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Bergerault, F., J. Fournier, and C. Bonnard. "Idiopathic congenital clubfoot: Initial treatment." Orthopaedics & Traumatology: Surgery & Research 99, no. 1 (February 2013): S150—S159. http://dx.doi.org/10.1016/j.otsr.2012.11.001.

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Zionts, Lewis E. "What’s New in Idiopathic Clubfoot?" Journal of Pediatric Orthopaedics 35, no. 6 (September 2015): 547–50. http://dx.doi.org/10.1097/bpo.0000000000000325.

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Werler, Martha M., Mahsa M. Yazdy, Allen A. Mitchell, Robert E. Meyer, Charlotte M. Druschel, Marlene Anderka, James R. Kasser, and Susan T. Mahan. "Descriptive epidemiology of idiopathic clubfoot." American Journal of Medical Genetics Part A 161, no. 7 (May 17, 2013): 1569–78. http://dx.doi.org/10.1002/ajmg.a.35955.

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Gelfer, Y., S. Wientroub, K. Hughes, A. Fontalis, and D. M. Eastwood. "Congenital talipes equinovarus." Bone & Joint Journal 101-B, no. 6 (June 2019): 639–45. http://dx.doi.org/10.1302/0301-620x.101b6.bjj-2018-1421.r1.

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AimsThe Ponseti method is the benchmark treatment for the correction of clubfoot. The primary rate of correction is very high, but outcome further down the treatment pathway is less predictable. Several methods of assessing severity at presentation have been reported. Classification later in the course of treatment is more challenging. This systematic review considers the outcome of the Ponseti method in terms of relapse and determines how clubfoot is assessed at presentation, correction, and relapse.Patients and MethodsA prospectively registered systematic review was carried out according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies that reported idiopathic clubfoot treated by the Ponseti method between 1 January 2012 and 31 May 2017 were included. The data extracted included demographics, Ponseti methodology, assessment methods, and rates of relapse and surgery.ResultsA total of 84 studies were included (7335 patients, 10 535 clubfeet). The relapse rate varied between 1.9% and 45%. The rates of relapse and major surgery (1.4% to 53.3%) and minor surgery (0.6% to 48.8%) both increased with follow-up time. There was high variability in the assessment methods used across timepoints; only 57% of the studies defined relapse. Pirani scoring was the method most often used.ConclusionRecurrence and further surgical intervention in idiopathic clubfoot increases with the duration of follow-up. The corrected and the relapsed foot are poorly defined, which contributes to variability in outcome. The results suggest that a consensus for a definition of relapse is needed. Cite this article: Bone Joint J 2019;101-B:639–645.

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Giesberts, R. B., E. E. G. Hekman, G. J. Verkerke, and P. G. M. Maathuis. "Rapid decrease of cast-induced forces during the treatment of clubfoot using the Ponseti method." Bone & Joint Journal 100-B, no. 12 (December 2018): 1655–60. http://dx.doi.org/10.1302/0301-620x.100b12.bjj-2018-0721.r1.

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Aims The Ponseti method is an effective evidence-based treatment for clubfoot. It uses gentle manipulation to adjust the position of the foot in serial treatments towards a more physiological position. Casting is used to hold the newly achieved position. At first, the foot resists the new position imposed by the plaster cast, pressing against the cast, but over time the tissues are expected to adapt to the new position and the force decreases. The aim of this study was to test this hypothesis by measuring the forces between a clubfoot and the cast during treatment with the Ponseti method. Patients and Methods Force measurements were made during the treatment of ten idiopathic clubfeet. The mean age of the patients was seven days (2 to 30); there were nine boys and one girl. Force data were collected for several weeks at the location of the first metatarsal and the talar neck to determine the adaptation rate of the clubfoot. Results In all measurements, the force decreased over time. The median (interquartile range) half-life time was determined to be at 26 minutes (20 to 53) for the first metatarsal and 22 minutes (9 to 56) for the talar neck, suggesting that the tissues of the clubfoot adapt to the new position within several hours. Conclusion This is the first study to provide objective force data that support the hypothesis of adaptation of the idiopathic clubfoot to the new position imposed by the cast. We showed that the expected decrease in corrective force over time does indeed exist and adaptation occurs after a relatively short period of time. The rapid reduction in the forces acting on the foot during treatment with the Ponseti method may allow significant reductions in the interval between treatments compared with the generally accepted period of one week.

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Widhe, Torulf, and Lotta Berggren. "Gait Analysis and Dynamic Foot Pressure in the Assessment of Treated Clubfoot." Foot & Ankle International 15, no. 4 (April 1994): 186–90. http://dx.doi.org/10.1177/107110079401500406.

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Gait analysis and dynamic foot pressure were used in a follow-up study of 42 children with idiopathic clubfeet. Mean age at follow-up was 9 years (range 4–15 years). Twenty-four of the 62 clubfeet were treated conservatively and 38 had at least one operative intervention. Gait analysis showed that the vertical and posterior ground forces were significantly lower from the clubfoot compared with the normal foot. Dynamic foot pressure demonstrated a significant shift of the center of pressure to the lateral side in the affected compared with the normal side. In bilateral clubfeet, a relationship between center of pressure and subjective complaints was observed.

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Nguyen, Julia, Jacob Veliky, Aedan Hanna, Jae Hoon Choi, Dhvani Shihora, Aleksandra McGrath, Neil Kaushal, Folorunsho Edobor-Osula, and Alice Chu. "The Impact of Treatment Method and Timing on the Long Term Outcomes of Pediatric Clubfoot Management." Foot & Ankle Orthopaedics 7, no. 4 (October 2022): 2473011421S0084. http://dx.doi.org/10.1177/2473011421s00848.

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Category: Other; Ankle; Hindfoot; Midfoot/Forefoot Introduction/Purpose: The Ponseti method of serial casting has been widely accepted as the new gold standard for management of idiopathic clubfoot, replacing joint invasive surgery, once the method-of-choice. While the short to midterm advantages of the method have been widely confirmed in the literature, there are limited comparative studies of the longer term outcomes. Dr. Ponseti's own definitive assessment of the long term result has not been decisively reevaluated by the literature. This systematic review compares the long-term functional outcomes of the two pediatric clubfoot management methods across different ages at treatment. Methods: A comprehensive search was conducted of PubMed, CINAHL, Web of Science, and Cochrane from inception to December 2020 to identify literature on clubfoot. Using PRISMA guidelines, the search terms clubfoot OR clubfeet OR clubbed foot OR clubbed feet OR talipes equinovarus were used. Articles containing more than three human subjects, were included. The database was searched for longitudinal studies of pediatric, idiopathic clubfoot management with the Ponseti method or joint invasive surgery. Retrospective studies of primary Ponseti treatment with serial casting or invasive soft tissue release and joint surgery that was performed on newly born and children up to twenty four months old and with reported mean follow-up of two years or longer were included. Evaluation reported according to different scoring systems were dichotomized as success (good to satisfactory results) or failure (residual or relapse that requires corrective management). Probability of less than 0.05 is considered statistically significant. Results: The initial search yielded 2907 articles, of which 29 articles reporting 2597 pediatric idiopathic clubfeet were included in this review, managed with either Ponseti casting, (group P = 1545 feet), or other surgical techniques, (group S = 1052 feet). The outcomes of 684 feet from group P with a mean long term follow up of 21+-13years were significantly superior to 1028 feet from group S with a mean follow up of 16+-5 years (p = 0.0002, odds ratio = 1.478). Multivariate analysis on 1310 feet from group P with mean age of 4.4 months (Range 1 - 8.9) against 794 feet from group S with mean age of 10.8 months (Range 1 - 22) detects no significant dependency on age (p = 0.128). Conclusion: The Ponseti method of serial casting resulted in significantly higher long term satisfaction outcomes compared with invasive surgical techniques in treatment of congenital clubfoot when performed within the first year of life. The findings supported Dr. Ponseti's own assessment regarding the high long term satisfaction rate (8+ years). Age was not found to be a significant contributor to the success of Ponseti casting over invasive surgery even though casting often started much earlier than surgery.

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Mahajan, Neetin, Ujwal Ramteke, Sandeep Gavhale, Nikhil Palange, Akash Mane, and Harshit Dave. "Ponseti technique: efficacy in idiopathic clubfoot in Indian population." International Journal of Research in Orthopaedics 4, no. 4 (June 23, 2018): 614. http://dx.doi.org/10.18203/issn.2455-4510.intjresorthop20182734.

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<p class="abstract"><strong>Background:</strong> The number of operations for clubfoot is many, but the results are not encouraging and more complications are encountered after operative treatment. Most surgeons believe manipulation to be easy; however they rarely complete the treatment and abandon it and go on to surgery. In the confusing scenario Ponseti Method evolved and proved across the world to be one of the most promising ways to correct club foot with low cost minimum surgery and good result in short period of time.</p><p class="abstract"><strong>Methods:</strong> 50 cases of idiopathic clubfeet (76 feet) were enrolled from a period of May 2006 to May 2008 in the department of Orthopaedic. Out of 50, 42 patients were followed-up for two years. Post tenotomy follow-up done every monthly for 3 months. At every visit babies were checked for any relapse and parents were counselled for the strict compliance with Foot Abduction Brace. The results of correction in 42 patients (64 feets) evaluated and compared with Ponseti's observation and other form of conservative management.<strong></strong></p><p class="abstract"><strong>Results:</strong> The analysis of results of correction of clubfeet deformity by Ponseti's method reveals around 95.30% of good to acceptable result as compared with Ponseti’s observation of around 99% which is comparable. We have observed 4.69% of poor result as compared with 1% observed by Ponseti.</p><p class="abstract"><strong>Conclusions:</strong> It is safe, efficient, Economical and most effective treatment for clubfoot which decreases the need for extensive corrective surgery. This technique can be used in children up to one year of age even after previous unsuccessful non-surgical treatment.</p>

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Scanlan, Emily, Kate Grima-Farrell, Emre IIhan, Paul Gibbons, and Kelly Gray. "Initiating Ponseti management in preterm infants with clubfoot at term age." Journal of Children's Orthopaedics 16, no. 2 (April 2022): 141–46. http://dx.doi.org/10.1177/18632521221080476.

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Purpose: Currently, the optimal time to initiate treatment among preterm infants with clubfoot is unknown. The aim of this study was to describe treatment outcomes up to 1 year post-correction following Ponseti management in infants who were born preterm but treated at term age. Methods: A retrospective chart audit was conducted at a major pediatric hospital on preterm infants with clubfoot who commenced Ponseti management at term age (≥37 weeks of gestation). Data are expressed as mean values (±standard deviation) or 95% confidence intervals (95% CIs). Results: Twenty-six participants (40 feet) born at 32.6/40 (±3.1) weeks of gestation were identified. Thirteen (50%) were male, 14 (54%) presented bilaterally, and 7 (27%) presented with syndromic clubfoot. Ponseti management was initiated at 41.4/40 (±2.8) weeks gestation. Baseline Pirani scores were 5.2 (95%CI: 4.8–5.6) in the idiopathic group and 5.7 (95%CI: 5.0–6.4) in the syndromic group. The number of casts to correction was 5.9 (95% CI: 5.1–6.6) for those with idiopathic clubfoot and 6.1 (95%CI: 5.0–7.3) for those with syndromic clubfoot. Achilles tenotomies were required in 13 (21 feet) with idiopathic clubfoot and five (7 feet) with syndromic clubfoot. Recurrence occurred in four infants (5 feet): 4 feet required further casting and bracing, and 1 foot required additional surgery. Conclusion: Ponseti management at term age in preterm-born infants yields comparable 1-year outcomes to term-born infants. Further research is required to determine whether outcomes beyond 1 year of age align with growth and development demonstrated by term-born infants who are managed with the Ponseti method. Level of evidence: Level IV.

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Chand, S., A. Mehtani, A. Sud, J. Prakash, A. Sinha, and A. Agnihotri. "Relapse following use of Ponseti method in idiopathic clubfoot." Journal of Children's Orthopaedics 12, no. 6 (December 2018): 566–74. http://dx.doi.org/10.1302/1863-2548.12.180117.

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Purpose We assessed the pattern of relapse as well as the correlation between the number of casts required for correction and Pirani and Dimeglio scores at presentation, and age at presentation. We hypothesized that the Ponseti method would be effective in treatment of relapsed clubfoot as well. Methods We evaluated 115 idiopathic clubfeet in 79 children presenting with relapse following treatment by the Ponseti method. The mean age was 33.8 months with mean follow-up of 24 months. All patients were assessed for various patterns of relapsed deformities. Quantification of deformities was done using the Pirani and Dimeglio scores. All relapsed feet were treated by a repeat Ponseti protocol. Results Non-compliance to a foot abduction brace was observed to be the main contributing factor in relapse, in 99 clubfeet (86%). Combination of three static deformities (equinus, varus and adduction) together was observed most commonly (38.3% feet). Overall, relapse of equinus deformity was noted most commonly followed by adduction. A painless plantigrade foot was obtained in all 115 feet with a mean of five casts. In all, 71 feet (61.7%) underwent percutaneous tenotomy. A total of 15 feet (13%) required tibialis anterior tendon transfer. Re-relapse rate in group 1 was 21% compared with 12.6% in group 2 and overall 16.5%. Conclusion We conclude that the Ponseti method is effective and the preferred initial treatment modality for relapsed clubfeet. Surgical intervention should be reserved for residual deformity only after a fair trial of Ponseti cast treatment. Regular follow-up and strict adherence to brace protocol may reduce future relapse rates. Further research is required to identify high-risk feet and develop individualized bracing protocol. Level of evidence: IV

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Divovich, G. V., A. A. Bronova, and T. I. Romanyuk. "Results of the treatment of congenital clubfoot and its relapses in children: outcomes of 8-year surgical practical work." Health and Ecology Issues, no. 2 (June 28, 2020): 35–42. http://dx.doi.org/10.51523/2708-6011.2020-17-2-5.

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Objective: to evaluate the results of minimally invasive surgical treatment of congenital idiopathic clubfoot and its relapses in children. Material and methods. The results of the treatment of 78 children with congenital idiopathic clubfoot (main group) over the period of 2010-2018 were analyzed in comparison with the results of the treatment of 41 children with relapsed congenital clubfoot, the primary treatment of which had been performed before 2010 (comparison group). Results. It has been found that in the treatment of congenital clubfoot using the Ponseti method relapses occur in no more than 21.79 % cases, and in traditional treatment - in 57.74% cases. The surgical treatment of the relapses using the Ponseti method is to perform release operations on the tendon-ligament apparatus from minimally invasive accesses, whereas cases of rigid chronic deformities require extensive releases on soft tissues, as well as resection-arthrodesis interventions on the joints of the foot. Conclusion. In the treatment of children with congenital clubfoot using the Ponseti method, the rate of relapses is twice as low as that in the application of traditional methods. Relapses in the treatment of congenital clubfoot in children occur mainly at the age of 5. Repeated relapses of foot deformation after the performance of minimally invasive operations did not occur during the study.

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Kruglov, Igor Yu, Nicolai Yu Rumyantsev, Gamzat G. Omarov, and Natalia N. Rumiantceva. "Change in the severity of congenital clubfoot in the first week of life." Pediatric Traumatology, Orthopaedics and Reconstructive Surgery 7, no. 4 (January 20, 2020): 49–56. http://dx.doi.org/10.17816/ptors7449-56.

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Backgrоund. Congenital clubfoot or congenital equino-cava-varus deformity of the feet is one of the most common pathologies of the musculoskeletal system in children. Numerous articles in global literature have been published about changes in clubfoot severity during treatment; however, there are very few reports on how the severity of foot deformities with congenital clubfoot changes during the first week of life in the absence of deformity correction. Aim. To analyze changes in the severity of congenital clubfoot in the first week of life without any treatment. Materials and methods. The study group included 28 newborns with idiopathic congenital clubfoot (a total of 40 feet). The severity of clubfoot was evaluated on days one and seven after birth using the Dimeglio and Pirani scores. Results. During the initial examination of the newborns on the first day of life, the clubfoot severity recorded on the Pirani score was between 2 to 3 points and between 9 to 15 points on the Dimeglio score. Thus, in the first seven days of life in all patients who did not receive treatment, there was a significant increase in the severity of the equino-cava-varus deformity of the feet (p 0.05). The results of this study confirm that the severity of congenital clubfoot increases in the first week of life. This necessitates the beginning of the correction of severe idiopathic clubfoot in the first days after birth. Conclusions. The severity of congenital clubfoot during the first week of life significantly increased in all feet studied (p 0.05: 2 higher than in the table). If left untreated in the first week after birth, the equinus deformity progresses followed by varus deformity, anterior forefoot reduction, and, to a lesser extent, rotation.

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Leo, Donato Giuseppe, Aisling Russell, Anna Bridgens, Daniel C. Perry, Deborah M. Eastwood, and Yael Gelfer. "Development of a core outcome set for idiopathic clubfoot management." Bone & Joint Open 2, no. 4 (April 1, 2021): 255–60. http://dx.doi.org/10.1302/2633-1462.24.bjo-2020-0202.r1.

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Aims This study aims to define a set of core outcomes (COS) to allow consistent reporting in order to compare results and assist in treatment decisions for idiopathic clubfoot. Methods A list of outcomes will be obtained in a three-stage process from the literature and from key stakeholders (patients, parents, surgeons, and healthcare professionals). Important outcomes for patients and parents will be collected from a group of children with idiopathic clubfoot and their parents through questionnaires and interviews. The outcomes identified during this process will be combined with the list of outcomes previously obtained from a systematic review, with each outcome assigned to one of the five core areas defined by the Outcome Measures Recommended for use in Randomized Clinical Trials (OMERACT). This stage will be followed by a two round Delphi survey aimed at key stakeholders in the management of idiopathic clubfoot. The final outcomes list obtained will then be discussed in a consensus meeting of representative key stakeholders. Conclusion The inconsistency in outcomes reporting in studies investigating idiopathic clubfoot has made it difficult to define the success rate of treatments and to compare findings between studies. The development of a COS seeks to define a minimum standard set of outcomes to collect in all future clinical trials for this condition, to facilitate comparisons between studies and to aid decisions in treatment. Cite this article: Bone Jt Open 2021;2(4):255–260.

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Charak, Sumeet Singh, Khalid Muzafar, and Omeshwar Singh. "Management of idiopathic clubfoot with Ponseti technique." International Journal of Research in Medical Sciences 5, no. 8 (July 26, 2017): 3355. http://dx.doi.org/10.18203/2320-6012.ijrms20173156.

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Background: Idiopathic congenital talipes equinovarus (club foot) is a complex deformity that is difficult to correct. The goal of treatment is to reduce or eliminate its four components so that the patient has a functional foot and leads a normal life.Methods: Study have treated 20 patients with 32 idiopathic clubfoot deformities using Ponseti method. The severity was assessed by modified pirani scoring.Results: The mean number of casts that were applied to obtain correction was 7.02 (range four to nine casts). Tenotomy was done in 30 feet. Thirty feet had good results. One patient developed recurrence of the deformity due to non-compliance of the use of orthrotics.Conclusions: The Ponseti method is a safe and effective treatment for congenital idiopathic clubfoot and radically decreases the need for corrective surgery. Non-compliance with orthotics main factor causing failure of the technique.

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Canavese, Federico, and Alain Dimeglio. "Idiopathic clubfoot: past, present and future." Annals of Translational Medicine 9, no. 13 (July 2021): 1094. http://dx.doi.org/10.21037/atm-21-2392.

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Kumar, S. Jay. "The Idiopathic Clubfoot and Its Treatment." Journal of Bone & Joint Surgery 69, no. 1 (January 1987): 158. http://dx.doi.org/10.2106/00004623-198769010-00032.

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Ponseti, Ignacio V., Miroslav Zhivkov, Naomi Davis, Marc Sinclair, Matthew B. Dobbs, and Jose A. Morcuende. "Treatment of the Complex Idiopathic Clubfoot." Clinical Orthopaedics and Related Research 451 (October 2006): 171–76. http://dx.doi.org/10.1097/01.blo.0000224062.39990.48.

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Mascard, E., E. Yamine, and R. Seringe. "Overcorrection in Treatment of Idiopathic Clubfoot." Journal of Pediatric Orthopaedics B 6, no. 4 (October 1997): 296. http://dx.doi.org/10.1097/01202412-199710000-00056.

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Heilig, Michael R., Richard V. Matern, Seth D. Rosenzweig, and James T. Bennett. "Current Management of Idiopathic Clubfoot Questionnaire." Journal of Pediatric Orthopaedics 23, no. 6 (November 2003): 780–87. http://dx.doi.org/10.1097/01241398-200311000-00017.

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O’Shea, Ryan M., and Coleen S. Sabatini. "What is new in idiopathic clubfoot?" Current Reviews in Musculoskeletal Medicine 9, no. 4 (September 30, 2016): 470–77. http://dx.doi.org/10.1007/s12178-016-9375-2.

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Hsu, Wellington K., Nitin N. Bhatia, Alexander Raskin, and Norman Y. Otsuka. "Wound Complications From Idiopathic Clubfoot Surgery." Journal of Pediatric Orthopaedics 27, no. 3 (April 2007): 329–32. http://dx.doi.org/10.1097/bpo.0b013e3180340d86.

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Kang, Michael Seungcheol, Il-Yeong Hwang, and Soo-Sung Park. "Radiographic Prognostic Factors for Selective Soft Tissue Release After Ponseti Failure in Young Pediatric Clubfoot Patients." Foot & Ankle International 39, no. 6 (February 15, 2018): 712–19. http://dx.doi.org/10.1177/1071100718755475.

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Background: Selective soft tissue release (SSTR), which includes a combination of abductor hallucis, tibialis posterior, and Achilles lengthening, has been used in patients with recurrent clubfoot deformity after Ponseti treatment. The aim of this study was to investigate the prognostic factors for recurrence of clubfoot deformity after SSTR. Methods: Consecutive patients with idiopathic clubfoot and residual or recurrent deformity after Ponseti treatment underwent SSTR between 2005 and 2013. The clinical and radiologic characteristics before and after SSTR were analyzed. The ability of radiologic factors to predict recurrence of clubfoot deformity was assessed using multivariate analysis. Rigid deformities of forefoot adduction, and hindfoot varus, and equinus were examined separately. Forty-three patients with 64 clubfeet were included. Results: Postoperative improvement in the talo–first metatarsal angle on the anteroposterior view, the talocalcaneal angle on the lateral view, and the tibiocalcaneal angle on the lateral view independently predicted recurrence after SSTR. Additionally, the preoperative talocalcaneal angles on the anteroposterior and lateral views were also significant predictors, but these angles did not significantly improve after SSTR. Conclusions: SSTR seems to be an effective surgical modality only in milder deformities. Among patients with poor talocalcaneal angles, a high percentage required further surgery. The present results may be useful for the choice of SSTR or more extensive surgery. Level of Evidence: Level III, retrospective case-control study.

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