Treatment of congenital clubfoot using Ponseti method with early application of plaster cast – our own experiences
Journal Title: Postępy Nauk Medycznych - Year 2013, Vol 26, Issue 6
Abstract
Introduction. Clubfoot is, apart from hip displasia, the most common congenital developmental malformation. Each year over 100.000 newborns worldwide are affected by this defect (1, 2). In Poland the frequency is estimated at 1-2/1000 births (1, 3, 4). Although usually isolated it can occur accompanied by other defects such as congenital torticollis, hip dysplasia, artrogryposis, myelomeningocele. When untreated results in disability, deformity and painful foot (1). Ponseti management has been recognised and used worldwide for over 50 years. The procedure is based on correction achieved gradually by serial casts, with or without tendon of Achilles tenotomy. The correction is maintained by splinting using a foot abduction brace up to the age of 2-4.Aim. The aim of this study is to evaluate the results of early application of plaster casts in the correction of the defect.Method. We analysed treatment results of 13 children born in Bielanski Hospital in 2008-2012. During and after treatment all feet were assessed using Pirani scale (2).Results. No recurrence of deformity was observed. Children needed 5 casting periods on average to obtain correction of cavus, adductus and varus. A percutaneous heel-cord tenotomy performed in the 6th week of treatment completed the correction of the equinus deformity. Plaster casts were applied for 7.5 weeks on average.Conclusions. In every case the method proved to be effective, fully accepted by parents and well tolerated by children. The positive results of therapy, limited troublesomeness and a short period of plaster immobilisation prompted us to continue treatment with this method.
Authors and Affiliations
Joanna Gradek, Tomasz Szafrański, Jerzy Michalak
Keywords
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