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Órgano Oficial del Colegio Mexicano de Ortopedia y Traumatología

2021, Number 2

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Acta Ortop Mex 2021; 35 (2)

Four years follow up in congenital talipes equino varus patients managed with Ponseti method

Gaytán-Fernández S, Ceballos-Juárez A, García-Galicia A, Muñoz-Gómez A, Martínez-Asención J, Barragán-Hervella R, Montiel-Jarquín A, Morales-Flores C

Language: Spanish
References: 16
Page: 197-200
PDF size: 129.05 Kb.


ABSTRACT

Introduction: Congenital talipes equino varus (club foot) is a frequent congenital deformity of the foot. The Ponseti method is the gold standard for treatment. It consists of foot manipulation with weekly serial cast, minimally invasive surgery and Dennis-Brown bar up to five years. Objective: To describe the follow-up of patients with PEVAC treated using the Ponseti method. Material and methods: Descriptive, longitudinal study, during 2013-2019, in patients with PEVAC managed with Ponseti method. We included patients with uni- or bilateral club foot, under two years of age, without prior surgery, whose parents signed informed consent. Patients with other malformations were excluded. Serial weekly cast was placed for 4-8 weeks, a tenotomy of the Achilles tendon was performed, and cast for three more weeks; then reverse footwear with Dennis-Brown bar. The revisions were recorded at day zero, at eight weeks and every three months up to five years of age. Correction of deformity and pain on walking was assessed. Results: There were 22 patients; 17 (77.3%) corrected more than 90% of the deformity, with adequate functionality and 86.3% without pain on gait, mean follow-up 3.9 years (1-7 years); six patients relapsed (27.27%) due to poor attachment, one re-treated with cast, and five with anterior tibial transfer, all successfully. Conclusions: The club foot managed with Ponseti method corrects more than 90% of the deformity and without or minimal pain with good adherence to treatment. We had a 27.27% recurrence in our series.


REFERENCES

  1. Pérez-Abela AL, Álvarez-Osuna RM, Conde-Otero M, Godoy-Abad N. Pie equinovaro congénito. Rev S Traum Ort. 2003; 23(1): 17-21.

  2. Matthew B.D, Morcuende J, Gurnett C, Ponseti I. Treatment of idiopathic clubfoot: an historical review. Iowa Orthop J. 2000; 20: 59-64.

  3. Tachdjian MO. Ortopedia pediátrica. Diagnóstico y tratamiento. Buenos Aires: Médica Panamericana, 1999; pp. 2621-744.

  4. Dahang Z, Hai L, Li Z, Jianlin L, Fangchun J. Results of clubfoot management using the ponseti method: do the details matter? A systematic review. Clin Orthop Relat Res. 2014; 472(4): 1329-36.

  5. Fripp AT, Singer M. The Kite treatment of congenital talipes equinovarus. Postgrad Med J. 1953; 29(334): 391-9.

  6. Matuszewski L, Gil L, Karski J. Early results of treatment for congenital clubfoot using the Ponseti method. Eur J Orthop Surg Traumatol. 2012; 22(5): 403-6.

  7. Ponseti I, Pirani S, Dietz F, Morcuende JA, Mosca V, Herzenberg JE, Weinstein S, Penny N, Steenbeek M. Pie Zambo: el método de ponseti. Global-HELP Publication 2003: 4-29.

  8. Zwik E, Kraus T, Maizen C, Steinwender G, Linhart WE. Comparison of Ponseti versus surgical treatment for idiopathic clubfoot. A short-term preliminary report. Clin Orthop Relat Res. 2009; 467(10): 2668-76.

  9. Arana-Hernández EI, Cuevas-De Alba C. Método de Ponseti en el tratamiento del pie equino varo: técnica de enyesado y tenotomi?a percutánea del tendón de Aquiles. Orthotips. 2015; 11(4): 186-194.

  10. García-Galicia A, Lara-Muñoz MC, Arechiga-Santamaría A, Montiel-Jarquín AJ, López-Colombo A. Validez y consistencia de una nueva escala (facial del dolor) y de la versión en español de la escala de CHEOPS para evaluar el dolor postoperatorio en niños. Cir Cir. 2012; 80(6): 510-5.

  11. Naranjo-Morales B. Eficacia del Método Ponseti en el tratamiento del pie equinovaro. Rev Int Cienc Podol. 2019; 13(2): 99-113.

  12. Scher DM, Feldman DS, van Bosse HJ, Sala DA, Lehman WB. Predicting the need for tenotomy in the Ponseti method for correction of clubfeet. J Pediatr Orthop. 2004; 24(4): 349-52.

  13. Smith P, Kuo K, Graf A, Krzak L, Flanagan A, Hassani S, Angela K, et al. Long-term results of comprehensive clubfoot release versus the Ponseti method: which is better? Clin Orthop Relat Res. 2014; 472: 1281-90.

  14. Haft GF, Walker CG, Crawford HA. Early clubfoot recurrence after use of the Ponseti method in a New Zealand population. J Bone Joint Surg Am. 2007; 89(3): 487-93.

  15. Chu A, Labar AS, Sala DA, van Bosse HJ, Lehman WB. Clubfoot classification: correlation with Ponseti cast treatment. J Pediatr Orthop. 2010; 30(7): 695-9.

  16. Manisha R, Priyanka K. Congenital clubfoot: a comprehensive review. Ortho & Rheum Open Access. 2017; 8(1): 001-5.



EVIDENCE LEVEL

IV




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