| BMC Musculoskeletal Disorders | |
| Manipulation and brace fixing for the treatment of congenital clubfoot in newborns and infants | |
| Guoxin Nan1  Yuxi Su1  | |
| [1] Ministry of Education Key Laboratory of Child Development and Disorders, Key Laboratory of Pediatrics in Chongqing, Chongqing International Science and Technology Cooperation Center for Child Development and Disorders, Department of Orthopaedics Children’s Hospital of Chongqing Medical University, Yuzhong District Zhongshan 2road 136#, Chongqing 400014, China | |
| 关键词: External rotation brace; Infant; Congenital; Pirani score; Clubfoot; | |
| Others : 1118370 DOI : 10.1186/1471-2474-15-363 |
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| received in 2014-02-18, accepted in 2014-10-20, 发布年份 2014 | |
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【 摘 要 】
Background
As one of the most common congenital deformities in children, clubfoot has long been a challenge for orthopedic surgeons. This paper describes the experience of our team with manipulation and above-the-knee brace fixation without percutaneous Achilles tenotomy for the treatment of clubfoot in newborns and infants.
Methods
In the orthopedic department of our hospital, 32 infants and newborns (56 feet) with congenital clubfoot underwent manipulation and above-the-knee brace fixation between 2008 and 2012. External rotation brace was used for 1–4 years during the night after deformity correction. Prospective follow-up for a mean duration of 29 months (range, 12–48 months) was carried out. The efficacy of the treatment was assessed by Pirani’s scoring system before and after treatment.
Results
Fifty-two feet achieved a normal appearance within 3 to 6 months (average, 4.2 months) after treatment. Two patients had skin pressure sores due to improper brace care, but these healed with no scarring after timely treatment. The mean Pirani score 1 year after treatment was 0.21 ± 0.09, whereas it was 4.93 ± 1.02 before treatment (p = 0.0078). No patient required treatment with percutaneous Achilles tenotomy.
Conclusion
The manipulation and brace fixation used in this study offer an effective method for correcting clubfoot deformity in newborns and infants. This treatment can be an alternative choice to percutaneous Achilles tenotomy.
【 授权许可】
2014 Su and Nan; licensee BioMed Central Ltd.
【 预 览 】
| Files | Size | Format | View |
|---|---|---|---|
| 20150206023152512.pdf | 2653KB | ||
| Figure 5. | 88KB | Image | |
| Figure 1. | 68KB | Image | |
| Figure 3. | 77KB | Image | |
| Figure 2. | 88KB | Image | |
| Figure 1. | 73KB | Image |
【 图 表 】
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【 参考文献 】
- [1]Pavone V, Bianca S, Grosso G, Pavone P, Mistretta A, Longo MR, Marino S, Sessa G: Congenital talipes equinovarus: an epidemiological study in Sicily. Acta Orthop 2012, 83(3):294-298.
- [2]Cummings RJ, Davidson RS, Armstrong PF, Lehman WB: Congenital clubfoot. J Bone Joint Surg Am 2002, 84-A(2):290-308.
- [3]Roye DP Jr, Roye BD: Idiopathic congenital talipes equinovarus. J Am Acad Orthop Surg 2002, 10(4):239-248.
- [4]Ji SJ, Pan SC, Wang JM: Pediatric Orthopaedics. Jinan: Shandong Science and Technology Press; 1998:177-183.
- [5]Yang JP, De DG: Early manual correction plus series cast immobilization for treatment of congenital club foot. Chin J Pediatr Surg 2003, 24:205-207.
- [6]Crawford AH, Gupta AK: Clubfoot controversies: complications and causes for failure. Instr Course Lect 1996, 45:339-346.
- [7]Herzenberg JE, Radler C, Bor N: Ponseti versus traditional methods of casting for idiopathic clubfoot. J Pediatr Orthop 2002, 22(4):517-521.
- [8]Ponseti IV: Treatment of congenital club foot. J Bone Joint Surg Am 1992, 74(3):448-454.
- [9]Ponseti IV: Clubfoot management. J Pediatr Orthop 2000, 20(6):699-700.
- [10]Dyer PJ, Davis N: The role of the pirani scoring system in the management of club foot by the ponseti method. J Bone Joint Surg (Br) 2006, 88(8):1082-1084.
- [11]Evans AM, Van Thanh D: A review of the ponseti method and development of an infant clubfoot program in Vietnam. J Am Podiatr Med Assoc 2009, 99(4):306-316.
- [12]Bouchoucha S, Smida M, Saied W, Safi H, Ammar C, Nessib MN, Ghachem MB: Early results of the ponseti method using the steenbek foot abduction brace: a prospective study of 95 feet. J Pediatr Orthop B 2008, 17(3):134-138.
- [13]van Bosse HJ: Ponseti treatment for clubfeet: an international perspective. Curr Opin Pediatr 2011, 23(1):41-45.
- [14]Chu A, Lehman WB: Persistent clubfoot deformity following treatment by the ponseti method. J Pediatr Orthop B 2012, 21(1):40-46.
- [15]Saetersdal C, Fevang JM, Fosse L, Engesaeter LB: Good results with the ponseti method: a multicenter study of 162 clubfeet followed for 2–5 years. Acta Orthop 2012, 83(3):288-293.
- [16]Hegazy M, Nasef NM, Abdel-Ghani H: Results of treatment of idiopathic clubfoot in older infants using the ponseti method: a preliminary report. J Pediatr Orthop B 2009, 18(2):76-78.
- [17]Derzsi Z, Gozar H, Gurzu S, Prisca R, Nagy O: Congenital clubfoot in children after walking age: management and evaluation of 41 feet with the dimeglio score. J Clin Diagn Res : JCDR 2013, 7(12):2841-2843.
- [18]Ma RX, Wang W, Zhao W: Short-term effect of early rehabilitation in treatment of congenital club. Chin J Pediatr Surg 2005, 26:253-255.
- [19]Laaveg SJ, Ponseti IV: Long-term results of treatment of congenital clubfoot. J Bone Joint Surg Am 1980, 62(1):23-31.
- [20]Changulani M, Garg NK, Rajagopal TS, Bass A, Nayagam SN, Sampath J, Bruce CE: Treatment of idiopathic club foot using the ponseti method. Initial experience. J Bone Joint Surg (Br) 2006, 88(10):1385-1387.
- [21]Morcuende JA, Dolan LA, Dietz FR, Ponseti IV: Radical reduction in the rate of extensive corrective surgery for clubfoot using the ponseti method. Pediatrics 2004, 113(2):376-380.
- [22]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):349-352.
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