RECENT ADVANCES IN THE TREATMENT OF CONGENITAL CLUBFOOT
Abstract
Background. In the article the etiology and pathological changes in congenital clubfoot are described. The manipulation and casting technique according to Ponseti is presented: the foot is abducted with dorsiflexion of the first ray while pressure is maintained on the lateral aspect of the talar neck in front of the lateral maleolus. The additional skin incision in the line of Achilles tendon is no longer used and the Cincinatti incision is slightly modified in the posterior part of the foot. The operative reposition of the talanavicular joint is in most of cases no longer necessary because of the succesful manipulation and casting technique according to Ponseti. Consequently, the operative time is shortened.
Conclusions. Due to recent advances in the treatment of congenital clubfoot patients stay in the hospital only 24 hour after surgery. However the course and result of congenital clubfoot remains to be impredictable to some degree, presumably etiological heterogenity.
Downloads
References
Martin RF, Milo-Manson G, McComas A, Levin S. Neurogenic origin of talipes equinovarus. In: Simons GW ed. The clubfoot. New York: Springer-Verlag, 1994: 39–9.
Sodre H, Bruschini S, Magalhaes AAC, Lourenco A. Anomalous muscles in clubfeet. In: Simons GW ed. The clubfoot. New York: Springer-Verlag, 1994: 42–2.
Hootnick DR, Packard DR Jr, Levinsohn EM, Wladis A. In: Simons GW ed. The clubfoot. New York: Springer-Verlag, 1994: 48–8.
Ippolito E, Ponseti IV. Congenital clubfoot in the human fetus: a histological study. J Bone Joint Surg (Am) 1980; 62: 8–15.
Bohm M. The embryologic origin of clubfoot. J Bone Joint Surg (Am) 1929; 11: 229–35.
Irani RN, Sherman SS. The pathological anatomy of clubfoot. J Bone Joint Surg (Am) 1963; 45: 45–52.
Robertson WJ, Corbett D. Congenital clubfoot: month of conception. Clin Orthop 1997; 338: 14–8.
Shimizu N, Hamada S, Mitta M, Hiroshima K, Ono K. Etiological considerations of congenital clubfoot deformity. In: Simons GW ed. The clubfoot. New York: Springer-Verlag, 1994: 31–8.
Mosca VS. The foot. In: Morrissy RT in Weinstein SL eds. Lovell and Winter’s pediatric orthopedics. Philadelphia: Lippincott Williams & Wilkins, 2001: 1151–215.
Dimeglio A, Bensahel H, Souchet P. Classification of clubfoot. J Pediatr Orthop B 1995; 4: 129–36.
Ponseti IV. Current concepts: Common errors in the treatment of congenital clubfoot. Int Orthop (SICOT) 1997; 21: 137–41.
Antolič V, Baebler B. Zdravljenje prirojenega ekvinovarusa: kirurška tehnika. Med Razgl 1995; 34: 385–94.
Crawford AH, Marxen JL, Osterfeld DL. The Cincinnati incision: a comprehensive approach for surgical procedures of the foot and ankle in childhood. J Bone Joint Surg (Am) 1985; 67: 1355–8.
Simons GW. Complete subtalar release in clubfoot. J Bone Joint Surg (Am) 1985; 67: 1044–55.
Turco VJ. Surgical correction of the resistant clubfoot – one stage posteromedial release with internal fixation: A preliminary report. J Bone Joint Surg (Am) 1971; 53: 477–97.
McKay DW. New concept and approach to clubfoot treatment: Section II – Correction of the clubfoot. J Pediatr Orthop 1983; 3: 10–21.
The Author transfers to the Publisher (Zdravniški vestnik/Slovenian Medical Journal) all economic copyrights following form Article 22 of the Slovene Copyright and Related Rights Act (ZASP), including the right of reproduction, the right of distribution, the rental right, the right of public performance, the right of public transmission, the right of public communication by means of phonograms and videograms, the right of public presentation, the right of broadcasting, the right of rebroadcasting, the right of secondary broadcasting, the right of communication to the public, the right of transformation, the right of audiovisual adaptation and all other rights of the author according to ZASP.
The aforementioned rights are transferred non-exclusively, for an unlimited number of editions, for the term of the statutory
The Author can make use of his work himself or transfer subjective rights to others only after 3 months from date of first publishing in the journal Zdravniški vestnik/Slovenian Medical Journal.
The Publisher (Zdravniški vestnik/Slovenian Medical Journal) has the right to transfer the rights, acquired parties without explicit consent of the Author.
The Author consents that the Article be published under the Creative Commons BY-NC 4.0 (attribution-non-commercial) or comparable licence.
