scholarly journals An Analysis of the Mechanical Properties of the Ponseti Method in Clubfoot Treatment

2019 ◽  
Vol 2019 ◽  
pp. 1-11
Author(s):  
Murtaza Kadhum ◽  
Mu-Huan Lee ◽  
Jan Czernuszka ◽  
Chris Lavy
Keyword(s):  
Soft Tissues ◽  
Ponseti Method ◽  
Tissue Growth ◽  
Matrix Remodeling ◽  
Foot And Ankle ◽  
Congenital Clubfoot ◽  
Posterior Aspect ◽  
Pediatric Foot ◽  
Significant Disability ◽  
Rate Limiting

Congenital clubfoot is a complex pediatric foot deformity, occurring in approximately 1 in 1000 live births and resulting in significant disability, deformity, and pain if left untreated. The Ponseti method of manipulation is widely recognized as the gold standard treatment for congenital clubfoot; however, its mechanical aspects have not yet been fully explored. During the multiple manipulation-casting cycles, the tendons and ligaments on the medial and posterior aspect of the foot and ankle, which are identified as the rate-limiting tissues, usually undergo weekly sequential stretches, with a plaster of Paris cast applied after the stretch to maintain the length gained. This triggers extracellular matrix remodeling and tissue growth, but due to the viscoelastic properties of tendons and ligaments, the initial strain size, rate, and loading history will affect the relaxation behavior and mechanical strength of the tissue. To increase the efficiency of the Ponseti treatment, we discuss the theoretical possibilities of decreasing the size of the strain step and interval of casting and/or increasing the overall number of casts. This modification may provide more tensile stimuli, allow more time for remodeling, and preserve the mechanical integrity of the soft tissues.

scholarly journals Rational selection of treatment methods in recurrent clubfoot

2021 ◽  
pp. 64-71
Author(s):  
G. V. Divovich
Keyword(s):  
Surgical Treatment ◽  
Bone Growth ◽  
Soft Tissues ◽  
Primary Treatment ◽  
Ponseti Method ◽  
Growth Potential ◽  
Idiopathic Clubfoot ◽  
Rational Selection ◽  
Congenital Clubfoot ◽  
Selection Of

Objective. Based on an analytical assessment of the results of surgical treatment of children with equinovarus foot deformity of various origins (idiopathic clubfoot, syndromic clubfoot), to determine a way of rational selection of surgical techniquesin each specifc case.Materials and methods. The results of the treatment of 78 children with congenital idiopathic clubfoot over the period 2010–2018 were assessed in comparison with the results of the treatment of 41 children with recurrent congenital clubfoot, whose primary treatment had been carried out before 2010. We have gained the experience in treating 30 children with severe clubfoot syndrome (meningomyelocele, CNS lesions, chromosomal diseases and others).Results. In the treatment of congenital clubfoot with the Ponseti method, recurrences occur in 21.79 % of the cases, and in the traditional treatment — in 57.74 %. The Ponseti surgical treatment of recurrences consists in performing release operations on the tendon-ligament apparatus from mini-accesses. Cases of rigid, long-standing deformities require extensive releases on soft tissues, as well as resection and arthrodesis interventions on the joints of the foot. The treatment of clubfoot syndrome requires “surgically aggressive” methods of correction in early childhood.Conclusion. In the idiopathic variants of clubfoot and its relapses, it is possible to correct the vicious position of the feet by minimally invasive operations with minimal damage to the tissues of the circumflex joints and without damage to the flexor tendons and their sheaths in the medial ankle area. Long-standing recurrent rigid variants, as well as syndromic clubfoot, presuppose the performance of extensive releases, osteotomies and arthrodetic resections of the joints of the foot at an early age. A promising direction for clubfoot correction in the process of child development is a surgery with the use of the bone growth potential of the lower leg and foot.

scholarly journals Results of the treatment of congenital clubfoot and its relapses in children: outcomes of 8-year surgical practical work

2020 ◽  
pp. 35-42
Author(s):  
G. V. Divovich ◽  
A. A. Bronova ◽  
T. I. Romanyuk
Keyword(s):  
Surgical Treatment ◽  
Minimally Invasive ◽  
Soft Tissues ◽  
Primary Treatment ◽  
Ponseti Method ◽  
Idiopathic Clubfoot ◽  
Congenital Clubfoot ◽  
Minimally Invasive Surgical ◽  
Minimally Invasive Surgical Treatment ◽  
Foot Deformation

Objective: to evaluate the results of minimally invasive surgical treatment of congenital idiopathic clubfoot and its relapses in children. Material and methods. The results of the treatment of 78 children with congenital idiopathic clubfoot (main group) over the period of 2010-2018 were analyzed in comparison with the results of the treatment of 41 children with relapsed congenital clubfoot, the primary treatment of which had been performed before 2010 (comparison group). Results. It has been found that in the treatment of congenital clubfoot using the Ponseti method relapses occur in no more than 21.79 % cases, and in traditional treatment - in 57.74% cases. The surgical treatment of the relapses using the Ponseti method is to perform release operations on the tendon-ligament apparatus from minimally invasive accesses, whereas cases of rigid chronic deformities require extensive releases on soft tissues, as well as resection-arthrodesis interventions on the joints of the foot. Conclusion. In the treatment of children with congenital clubfoot using the Ponseti method, the rate of relapses is twice as low as that in the application of traditional methods. Relapses in the treatment of congenital clubfoot in children occur mainly at the age of 5. Repeated relapses of foot deformation after the performance of minimally invasive operations did not occur during the study.

Pediatric foot and ankle

2000 ◽  
Vol 11 (6) ◽  
pp. 438-442 ◽  
Author(s):  
John G. Thometz
Keyword(s):  
Foot And Ankle ◽  
Pediatric Foot

Fractures of the Pediatric Foot and Ankle

2019 ◽  
pp. 257-279
Author(s):  
Brian B. Carpenter ◽  
Mitzi L. Williams
Keyword(s):  
Foot And Ankle ◽  
Pediatric Foot

scholarly journals The impact of the early tenotomy of Achilles tendon on the length and results of congenital clubfoot severe forms treatment

2019 ◽  
Vol 76 (8) ◽  
pp. 795-801
Author(s):  
Zoran Rakonjac
Keyword(s):  
Achilles Tendon ◽  
Negative Impact ◽  
Ponseti Method ◽  
Congenital Clubfoot ◽  
Results Of Treatment ◽  
Analysis Of Results ◽  
Group 2 ◽  
The Impact ◽  
Group 1 ◽  
Female Subjects

Background/Aim. In this paper we present our modification of the Ponseti method which we have been using for the treatment of severe forms of congenital clubfoot since 2007. The aim of this paper was to determine, on the basis of the analysis of results, the impact of the early tenotomy of the Achilles tendon on the length and results of treatment of severe forms of congenital clubfoot. Methods. The study was prospective and lasted from 2007 to 2016 year. It was implemented in the Clinic for Children's Surgery Banjaluka. The Group 1 consisted of the subjects treated by the modified Ponseti method in the period of 9 years (2007?2016). There were a total of 30 subjects (52 feet). There were 20 (67%) of male and 10 (33%) of female subjects. There were 22 (77%) subjects with bilateral and 8 (27%) with unilateral deformity. The Group 2 consisted of the subjects treated by the classic Ponseti method in the period of 9 years (2007?2016). There were a total of 32 subjects (52 feet). There were 26 (81%) of male and 6 (19%) of female subjects. There were 20 (63%) of subjects with bilateral and 12 (37%) with unilateral deformity. We used the Pirani score for: classification of deformity according to the severity, monitoring of results of the correction, determination of indication for tenotomy of the Achilles tendon and for the analysis of results of the treatment. Results. The total length of treatment in the Group 1 was from 6 to 9 weeks (mean = 6.71 ? 0.871), and in the Group 2 from 9 to 12 weeks (mean = 9.92 ? 0.882) (r = 0.86; p = 0.001). There was no difference in the results of the treatment (?2 = 2.372 df = 2 n = 52 p = 0.936. Conclusion. Applying early tenotomy of Achilles tendon in the treatment of severe forms of congenital club foot significantly shortens the duration of treatment and has no negative impact on the results of treatment.

scholarly journals MODERN CONCEPTS OF CONSERVATIVE TREATMENT METHODS OF CLUBFOOT

2014 ◽  
Vol 2 (4) ◽  
pp. 20-31
Author(s):  
Irina Yurievna Klychkova ◽  
Yuri Alexeevich Lapkin ◽  
Mikhail Pavlovich Konyukhov ◽  
Yulia Aleksandrovna Stepanova ◽  
Vladimir Markovich Kenis
Keyword(s):  
Conservative Treatment ◽  
Ponseti Method ◽  
The Other ◽  
Long Term Results ◽  
Treatment Results ◽  
Congenital Clubfoot ◽  
Functional Methods ◽  
The World ◽  
Accepted Standard

Conservative treatment of congenital clubfoot is generally accepted standard in the world orthopedic practice. There are many techniques that basically include functional methods and techniques of passive correction of the deformity. We analyzed 10 years of experience in the treatment of primary clubfoot according to three techniques - Zatsepin’s method, author’s method and Ponseti method. The evaluation of treatment results in the short and long terms was carried out. Analysis of long-term results showed a statistically significant advantage of Pontseti method over the other used techniques.

scholarly journals Correction to: The Pediatric Foot and Ankle

2020 ◽  
pp. C1-C1
Author(s):  
Michelle L. Butterworth ◽  
John T. Marcoux
Keyword(s):  
Foot And Ankle ◽  
Pediatric Foot

Common Foot and Ankle Disorders in Adults and Children

2015 ◽  
Vol 19 (2) ◽  
pp. 54-65 ◽  
Author(s):  
Ganesan Balasankar ◽  
Luximon Ameersing
Keyword(s):  
Soft Tissues ◽  
Adult Population ◽  
Complex Structure ◽  
Whole Body ◽  
Clinical Aspects ◽  
Foot Deformities ◽  
Foot And Ankle ◽  
Human Foot ◽  
Flat Feet ◽  
Adults And Children

The human foot is a complex structure, which includes bones, joints, muscles, ligaments, soft tissues, nerves and veins. It supports the weight of the whole body and helps one to walk, run, and jump. Ankle and foot biomechanical functions that are interrupted by various pathological deformities lead to pain or other deformities, and result in difficulties during mobility. Foot problems are very common in children and adults. In this article, attempts are made to explore the clinical aspects of the most common foot and ankle deformities and their management by children and adults. Foot deformities may be congenital or acquired, and may involve arthritis conditions, such as rheumatoid arthritis and osteoarthritis. In children, congenital clubfoot, cavus, and flat feet are the most common disorders and can be treated by non-operative means or surgical management. Hallux valgus and rigidus, lesser toe deformities, and arthritis are mostly present with or without pain in the adult population.

scholarly journals Treatment of idiopathic congenital clubfoot using the Ponseti method: ten years of experience

2013 ◽  
Vol 48 (4) ◽  
pp. 362-367
Author(s):  
Luiz Carlos Ribeiro Lara ◽  
Delmo João Carlos Montesi Neto ◽  
Fagner Rodrigues Prado ◽  
Adonai Pinheiro Barreto
Keyword(s):  
Ponseti Method ◽  
Years Of Experience ◽  
Congenital Clubfoot
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