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Treatment of clubfoot in young children with arthrogryposis by Ponseti method: possibilities and perspectives
- Authors: Derevyanko D.V.1, Agranovich O.E.1, Buklaev D.S.1, Petrova E.V.1, Trofimova S.I.1
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Affiliations:
- Turner Scientific and Research Institute for Children’s Orthopedics
- Issue: Vol 20, No 1 (2014)
- Pages: 51-58
- Section: Clinical studies
- URL: https://journal.rniito.org/jour/article/view/43
- DOI: https://doi.org/10.21823/2311-2905-2014-0-1-51-58
- ID: 43
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Abstract
Background. Clubfoot is the most common deformity in arthrogryposis and is characterized by a high degree of rigidity and a tendency to relapse. At present, no consensus exists on the issue of treatment of this pathology. The aim of this study was to demonstrate the possibilities of Ponseti method for the treatment of clubfoot in the younger children with arthrogryposis. Material and methods. The study was based on an analysis of treatment outcomes in 64 children (124 feet) under 3 years. 50 patients (78%) had a congenital multiple arthrogryposis, 14 children (22%) had a distal form of the disease. All the children underwent conservative treatment using Ponseti method. Results. After phased plastering by Ponseti method, the children with congenital multiple arthrogryposis aged under 1 year demonstrated correction of deformity components in 25 (48%) feet and the children from 1 to 3 years in 4 (8.7%) feet. Phased plastering in the children under 1 year with the distal form of the disease resulted in the correction in all 7 (100%) feet. In the patients with a similar form of the disease aged from 1 to 3 years, correction was achieved in 3 (23%) feet. In the cases of incomplete correction of deformity elements, when the possibilities of phased plastering were exhausted, different surgical interventions were performed. However, in neither case the surgery to remove talus was required. Conclusion. Ponseti method is most effective for the treatment of clubfoot in the children of the first year. Application of this method allows for elimination of clubfoot or significant reduction of the volume of subsequent surgery.
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About the authors
D. V. Derevyanko
Turner Scientific and Research Institute for Children’s Orthopedics
Author for correspondence.
Email: dionis1976@inbox.ru
Russian Federation
O. E. Agranovich
Turner Scientific and Research Institute for Children’s Orthopedics
Email: olga_agranovich@yahoo.com
Russian Federation
D. S. Buklaev
Turner Scientific and Research Institute for Children’s Orthopedics
Email: dima@buklaev.com
Russian Federation
E. V. Petrova
Turner Scientific and Research Institute for Children’s Orthopedics
Email: pet_kitten@mail.ru
Russian Federation
S. I. Trofimova
Turner Scientific and Research Institute for Children’s Orthopedics
Email: trofimova_sv2012@mail.ru
Russian Federation
References
- Агранович О.Е, Баиндурашвили А.Г., Петрова Е.В., Сапоговский А.В., Неуймина М.В., Рождественский В.Ю., Трофимова С.И., Коченова Е.А., Буклаев Д.С., Микиашвили Е.Ф., Янаков Д.Я. Консервативное лечение деформаций верхних и нижних конечностей у детей раннего возраста с артрогрипозом. Детская хирургия. 2012; (2): 10-15
- Бландинский В.Ф., Вавилов М.А., Торно Т.Э., Донской А.В. Лечение атипичной косолапости методом Понсети. Травматология и ортопедия России. 2010; (1):75-79
- Кенис В.М., Клычкова И.Ю., Степанова Ю.А. Метод Понсети в лечении сложных и нейрогенных форм косолапости у детей. Вестник травматологии и ортопедии им. Н.Н. Приорова. 2011; (4): 67-70
- Петрова Е.В., Конюхов М.П. Лечение эквино-кававарусной деформации стоп у детей раннего возраста с артрогрипозом: медицинская технология. СПб.: НИДоИ им Г.И. Турнера; 2008. 18 с
- Boehm S., Lympaphayom N., Alaee F., Sinclair M.F., Dobbs M.B. Early results of the Ponseti method for the treatment of clubfoot in distal arthrogryposis. J. Bone Joint Surg. (Am). 2008; 90:1501-1507.
- Catterall A.A. Method of assessment of the clubfoot deformity. Clin. Orthop. 1991; (264):48-53.
- Choi I.H., Yang M.S., Chung C.Y., Cho T.J., Sohn Y.J. The treatment of recurrent arthrogrypotic club foot in children by Ilizarov method. J. Bone Joint Surg. (Br). 2001; 83 (5): 731-737.
- Drummond D.S., Cruess R.L. The management of the foot and ankle in arthrogryposis multiple congenita. J. Bone Joint Surg. (Br). 1978; 60 (1): 96-99.
- Herzenberg J.E., Radler C., Bor N. Ponseti versus traditional methods of casting idiopathic clubfoot. J. Pediatr. Orthop. 2002; 22:517-521.
- Kowalczyk B., Lejman T. Short-term experience with Ponseti casting and the Achilles tenotomy method for clubfeet treatment in arthrogryposis multiplex congenita. J. Child. Orthop. 2008; 2 (5): 365-371.
- Legaspi J., Li Y.H., Leong J. Talectomy in patients with recurrent deformity in club foot. J. Bone Joint Surg. (Br). 2001; 83(3): 384-387.
- Lloyd-Roberts G.S., Lettin A.W.F. Arthrogryposis Multiplex Congenita. J. Bone Joint Surg. (Br). 1970; 52(3): 494-507.
- Menelaus M.B. Talectomy for equinovarus deformity in arthrogryposis and spina bifida. J. Bone Joint Surg. (Br). 1971; 53 (3): 468-473.
- Morcuende J.A., Dobbs M.B., Frick S.L. Results of the Ponseti method in patients with clubfoot associated with arthrogryposis. Iowa Orthop J. 2008; 28: 22-26.
- Obeidat M., Audat Z., Khriesat W. Short-term functional outcome in children with arthrogryposis multiplex congenita after multiple surgeries at an early age. J. Multidisciplinary Healthcare. 2012; 5: 195-200.
- Ponseti I.V. Congenital clubfoot: fundamentals of treatment. Oxford: Oxford University Press; 1996.
- Staheli L.T., Hall J.G., Jaffe K.M. Arthrogryposis. A text Atlas. Cambridge: Cambridge University Press; 2008.
- Van Bosse J.P.H., Marangoz S., Lehman W.B. Correction of arthrogrypotic clubfoot with a modified Ponseti method. Clin. Orthop. 2009; (467): 1283-1293.
- Wainwright A.M. The classification of congenital talipes equinovarus. J. Bone Joint Surg. (Br) 2002; 84 (7): 1020-1024.
- Widmann R.F., Do T.T., Burke S.W. Radical soft-tissue release of the arthrogrypotic clubfoot. J. Pediatr. Orthop. (Br). 2005; 14 (2):111-115.
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