scholarly journals The significance of foot length at the initiation of the Ponseti method: a prospective study

2019 ◽  
Vol 13 (3) ◽  
pp. 252-257 ◽  
Author(s):  
Y. Hemo ◽  
A. Yavor ◽  
R. Gigi ◽  
S. Wientroub
Keyword(s):  
Prospective Study ◽  
Ponseti Method ◽  
Functional Score ◽  
Idiopathic Clubfoot ◽  
Level Of Evidence ◽  
Results Of Treatment ◽  
Foot Length ◽  
Pirani Score ◽  
Additional Surgery ◽  
A Prospective Study

Objectives We sought to evaluate foot length (FL) and forefoot circumference (FC) and their impact on the severity of idiopathic clubfoot (CF) and results of treatment. We hypothesized that a smaller foot size at birth that represents a lesser than term newborn may affect the response of the CF to the treatment. Methods We conducted a prospective study documenting FL and FC of all neonates presented with idiopathic CF. Additional demographic information was collected. Outcome measures were number of casts needed for correction, need for recasting, additional surgery and functional score. Results In all, 52 children with 73 CF with a minimum mean follow-up of two years (2.0 to 5.6; sd 1.08) were evaluated. Mean gestational age was 38.63 weeks and mean birth weight (BW) was 3184 g. The mean FL at presentation was 74 mm (5.70 to 9.00), initial Pirani score was 5.5 (2.5 to 6.0) while number of casts was 6.9 (4.0 to 11.0). The FL was significantly correlated both to initial Pirani score (r = -0.35; p < 0.01) and number of casts (r = -0.33; p < 0.05). Positive correlation was found between the number of casts to Pirani score and number of additional procedures (r = 0.39; r = 0.36; p < 0.01, respectively). A foot size of up to 8 cm, needed 7.3 casts (4 to 7) compared with a FL of 8 cm or longer who needed 4.7 casts (4 to 6; t = 7.11; p < 0.001). Conclusion FL is a simple approach to identify preterm babies. It can be used as part of the initial evaluation of CF and help in predicting the course of treatment. We recommend adding FL to the existing classification. Level of Evidence I - Prognostic study

scholarly journals RESULTS OF TREATMENT OF IDIOPATHIC CONGENITAL CLUBFOOT IN CHILDREN: A 3-YEAR FOLLOW UP STUDY

2020 ◽  
Vol 73 (12) ◽  
pp. 2640-2643
Author(s):  
Oleksii O. Holubenko ◽  
Anatolii F. Levytskyi ◽  
Oleksandr V. Karabenyuk
Keyword(s):  
Soft Tissue ◽  
Recurrence Rate ◽  
Primary Treatment ◽  
Nonparametric Tests ◽  
Ponseti Method ◽  
Soft Tissue Release ◽  
Idiopathic Clubfoot ◽  
Results Of Treatment ◽  
Pirani Score ◽  
Serial Casting

The aim: Was to analyze the outcome, recurrence rate and complications between Ponseti method and soft-tissue release 3 yearsafter the initial treatment. Materials and methods: This prospective cohort study was conducted in congenital idiopathic clubfoot patients who underwent primary treatment by either Ponseti serial casting or soft tissue release between 2006 to 2016 at department of traumatology and orthopedics National Children’s Specialized Hospital “Okhmatdet”. Total of 113 feet in 95 patients (61 males and 34 females), sixty-two feet (62 patients) were in the Ponseti group and thirty-three feet (33 patients) were in the surgical treatment group. For both groups, descriptive statistics were calculated Pirani score (2004) result before and 3 years after treatment, recurrence rate and complications. The comparison of the Pirani score result and complications between the two groups was analyzed by nonparametric tests (Mann-Whitney U-tests). Statistical data processing was performed in SPSS 17.0 program. Results: The results of Pirani score reveal satisfactory outcomes for both groups. But Ponseti method has the more conservative approach and lower complication rate (11,29±5,27% and 24,24±11,74%, p=0,52). Conclusions: Ponseti method is a safe, effective method for treatment of congenital idiopathic clubfoot in children from first days after birth. Open surgery should be reserved for deformity that cannot be completely corrected or for treatment of recurrences.

scholarly journals Clinico-Sonographical Evaluation of Idiopathic Clubfoot and its Correction by Ponseti Method-A Prospective Study

2018 ◽  
Vol 06 (01) ◽  
Author(s):  
Sumit Chawla ◽  
Mallika Gupta ◽  
Varun Pandey ◽  
Abhishek Jain ◽  
Manoj Kumar
Keyword(s):  
Prospective Study ◽  
Ponseti Method ◽  
Idiopathic Clubfoot ◽  
A Prospective Study

Clinico-sonographical evaluation of idiopathic clubfoot and its correction by Ponseti method — A prospective study

The Foot ◽  
2017 ◽  
Vol 33 ◽  
pp. 7-13 ◽  
Author(s):  
Sumit Chawla ◽  
Mallika Gupta ◽  
Varun Pandey ◽  
Abhishek Jain ◽  
Manoj Kumar
Keyword(s):  
Prospective Study ◽  
Ponseti Method ◽  
Idiopathic Clubfoot ◽  
A Prospective Study

scholarly journals Ponseti treated idiopathic clubfoot - outcome predictive factors in the test of time: analysis of 500 feet followed for five to 20 years

2021 ◽  
pp. 1-7
Author(s):  
Yoram Hemo ◽  
Ariella Yavor ◽  
Meirav Kalish ◽  
Eitan Segev ◽  
Shlomo Wientroub
Keyword(s):  
Cost Effective ◽  
Functional Score ◽  
Idiopathic Clubfoot ◽  
Level Of Evidence ◽  
Achilles Tenotomy ◽  
Pirani Score ◽  
Institutional Review ◽  
Level Ii ◽  
Chi Squared ◽  
Initial Correction

Purpose To investigate a set of risk factors on the outcome of Ponseti treated idiopathic clubfeet (ICF). Methods This study was approved by the institutional review board. A retrospective analysis of prospectively gathered data over a 20-year period, at a single dedicated clubfoot clinic. Records of 333 consecutive infants with 500 ICF were analyzed. Initial Pirani score, number of casts, need for tenotomy, foot abduction brace compliance and functional score had been documented. The need for surgery after initial correction was the outcome measure. All children were followed by the same team throughout the study period. Descriptive statistics, chi-squared and multivariate analysis were performed. Results In total, 82 children (24%) with 119 feet (23.8%) were operated on, with 95.1% of feet being operated up to the age of nine years. There was a significant correlation between the Pirani score at presentation and the number of surgical procedures (chi-squared = 79.32; p < 0.001). Achilles tenotomy was done in 94.8% of patients. Pirani score of > 4.5 before casting was strongly associated with increased surgical risk (odds ratio = 1.95). When six to eight cast changes were needed, surgical prospect was 2.9 more, increasing to 11.9 when nine or more casts were needed. Conclusion Foot severity and number of cast changes were the strongest predictors for future surgery. Estimation of the risk of deformity recurrence after initial correction may help in tailoring a cost-effective personal treatment and follow-up protocol. Personalized focused protocol will help patients and caregivers and will reduce expenses. Level of Evidence Level II - prognostic study.

scholarly journals Idiopathic clubfoot treated by Ponseti method: a series of 300 cases

2018 ◽  
Vol 4 (6) ◽  
pp. 954
Author(s):  
Sunil Kumar Bhatiwal ◽  
B. L. Chopra ◽  
B. L. Khajotia ◽  
Shakti Chauhan
Keyword(s):  
Prospective Study ◽  
Clinical Evaluation ◽  
Excellent Result ◽  
Ponseti Method ◽  
Idiopathic Clubfoot ◽  
Congenital Deformities ◽  
Pirani Score ◽  
The Mean

<p class="abstract"><strong>Background:</strong> Clubfoot is a complicated deformity of the foot. It is one of the commonest congenital deformities in children. The main aim of this study was to evaluate the efficacy management of clubfoot by Ponseti method.</p><p class="abstract"><strong>Methods:</strong> This prospective study included 300 children (456 club feet) below the age of 2 years with idiopathic clubfeet from January 2013 to December 2017. In all the cases the Ponseti method was used for the management. The severity of the deformity was assessed with the help of the Pirani score and clinical evaluation of the foot was done.<strong></strong></p><p class="abstract"><strong>Results:</strong> Out of 300 patients 204 patients were male and 96 patients were female and 144 were unilateral clubfoot and 156 were bilateral cases of clubfoot. The mean number of casts required for correction was 5.4 (4–10). Out of 456 clubfeet 356 (78%) feet were required tenotomy. There was relapse seen in 36 (7.9%) feet which had to be managed with 2–3 serial manipulations and casting and these resolved. Excellent result found in our study in 92% cases, good results were found in 5% cases and poor results were found in 3% cases.</p><p class="abstract"><strong>Conclusions:</strong> Ponseti technique is a very useful and effective method of management of idiopathic clubfoot up to 2 year of age.</p>

To Evaluate the Role of Pirani Score in Deformity Assessment and Management of Club Foot by Ponseti Method – A Hospital Based Prospective Study from Tirupati

2021 ◽  
Vol 8 (29) ◽  
pp. 2633-2638
Author(s):  
Venkat R ◽  
Suguru Rav Kumar ◽  
Penugonda Ravi Shankar ◽  
Deety Lakshmi Venkatesh
Keyword(s):  
Prospective Study ◽  
Scoring System ◽  
Club Foot ◽  
Study Groups ◽  
Ponseti Method ◽  
Classification Systems ◽  
Statistical Inferences ◽  
Pirani Score ◽  
Ethical Approval

BACKGROUND Pirani scoring system is one of the classification systems in management of club foot which is simple and easy to use. However, there is paucity of studies using Pirani system to determine the severity and monitor progress in the treatment of club foot. We therefore set out with the aim of assessing severity and monitoring the progress of treatment using the Pirani scoring system. The Pirani scoring system, together with the Ponseti method of club foot management, was assessed for its predictive value. METHODS It was a hospital-based prospective study of 57 club foot in 41 patients designed to evaluate the role of Pirani score in deformity assessment and management of club foot by Ponseti method. Consecutive patients presenting at the outpatient department at SVRRGGH, Tirupati with idiopathic club foot, and in-patients department with idiopathic club foot were recruited into the study. Informed consent was obtained from parents/guardians of the patients that were recruited in the study. This was a prerequisite for obtaining the ethical approval. Data collected from the study groups was entered into a worksheet, and analysis was performed using the statistical package for social sciences (SPSS) software for windows version 21. Significant statistical inferences were drawn at p & lt ; 0.05. RESULTS The correlation between the midfoot score, hindfoot score, Pirani score and the number of casts to achieve correction was significant (P = 0.001). Also, there was correlation between the Pirani score and the need for tenotomy (P = 0.001); between the number of casts to achieve correction and the need for tenotomy (P = 0.001). Moreover, the progress of treatment can be monitored with the Pirani score (P = 0.001). CONCLUSIONS Pirani scoring system is a simple, easy, quick and reliable system to determine severity and monitor progress in the treatment of club foot with excellent interobserver variability. KEYWORDS Pirani Score, Club Foot, Ponseti Method

scholarly journals Prospective Study of Gross Motor Milestones in Children with Severe Idiopathic Clubfoot Treated by Ponseti Method

2020 ◽  
Author(s):  
Chaitrali Shrikant Gundawar ◽  
Sameer Shrikrishna Desai ◽  
Santosh Shridhar Borkar ◽  
Ashish Ranade ◽  
Shyamal Patel ◽  
...  
Keyword(s):  
Prospective Study ◽  
Ponseti Method ◽  
Idiopathic Clubfoot ◽  
Gross Motor

Assessment of scapholunate instability with dynamic computed tomography

2019 ◽  
Vol 45 (4) ◽  
pp. 375-382 ◽  
Author(s):  
Lionel Athlani ◽  
Kamel Rouizi ◽  
Jonathan Granero ◽  
Gabriela Hossu ◽  
Alain Blum ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Prospective Study ◽  
Gap Size ◽  
Dynamic Computed Tomography ◽  
Level Of Evidence ◽  
Plain Radiographs ◽  
Scapholunate Instability ◽  
The Mean ◽  
A Prospective Study

We performed a prospective study to evaluate the values of dynamic four-dimensional computed tomography in assessing suspected chronic scapholunate instability. Forty patients were evaluated with radiographs, arthrography, and four-dimensional computed tomography. On plain radiographs and computed tomography, we found 16 patients with definite scapholunate instability, five with questionable scapholunate instability, and 19 with absence of scapholunate instability. We used four-dimensional computed tomography to evaluate the size of the scapholunate gap during radioulnar deviation. The mean and maximal values of the gap size were lowest in the patients with absence of scapholunate instability and highest in those with definite scapholunate instability. When comparing the scapholunate gap sizes of the patients with absent and questionable scapholunate instability, the range of the gap sizes was significantly higher in the patients with questionable scapholunate instability. We conclude that four-dimensional computed tomography aids assessment of chronic scapholunate instability, which allows the differentiation between patients without and those with definite or questionable scapholunate instability. Level of evidence: II

scholarly journals Additional challenges in children with idiopathic clubfoot: is it just the foot?

2019 ◽  
Vol 13 (3) ◽  
pp. 245-251 ◽  
Author(s):  
E. Lööf
Keyword(s):  
Motor Skills ◽  
Developmental Disorders ◽  
Ponseti Method ◽  
Control Group ◽  
Idiopathic Clubfoot ◽  
Level Of Evidence ◽  
Gross Motor ◽  
Assessment Protocol ◽  
Related Quality ◽  
Health Related

Purpose Treatment of idiopathic clubfoot (IC) has improved since the introduction of the Ponseti method. However, relapses are still common and primarily related to non-adherence to the brace regime. Our hypothesis was that IC might be more than just a structural deformity. Based on three studies, the aim of this paper was to provide an overview of findings regarding additional challenges within IC. Methods In total, 153 children with IC and 137 control children participated in the studies. The first study assessed gross motor skills in six motor tasks using the Clubfoot Assessment Protocol. The second and third studies surveyed neurodevelopmental difficulties (NDDs) using the Five to Fifteen (FTF) questionnaire and health-related quality of life (HRQoL) using the EuroQol-5D youth. Results A high percentage of gross motor deviations were found in children with IC compared with controls, and those correlated poorly with clubfoot severity and foot movement. Children with IC had a higher prevalence of NDDs on the FTF compared with the control group, including the domains: motor skills, perception and language. One-third of children with IC were defined as at risk of developmental disorders. In this subgroup, parents were less satisfied with the outcome of clubfoot treatment and the children reported worse HRQoL than those without NDDs. Conclusion The findings suggest additional challenges in children with IC, such as NDDs, apparently affecting both clubfoot treatment outcome and HRQoL. Thus, awareness of these challenges could be vital to further optimize treatment and support, for example, with regards to brace adherence. Level of Evidence II - Prognostic study

scholarly journals PROSPECTIVE STUDY OF INJURIES OCCURRED DURING BRAZILIAN FOOTBALL CHAMPIONSHIP IN 2019

2021 ◽  
Vol 29 (4) ◽  
pp. 207-210
Author(s):  
GUSTAVO GONÇALVES ARLIANI ◽  
PAULO HENRIQUE SCHMIDT LARA ◽  
GABRIEL FURLAN MARGATO ◽  
DIOGO CRISTIANO NETTO ◽  
MOISÉS COHEN ◽  
...  
Keyword(s):  
Risk Factors ◽  
Prospective Study ◽  
Gold Standard ◽  
Common Type ◽  
Muscle Strain ◽  
Muscle Injuries ◽  
Level Of Evidence ◽  
Mapping System ◽  
A Prospective Study ◽  
Type Of Injury

ABSTRACT Objective: To determine the incidence and risk factors for injuries that occurred during the matches of the Brazilian Football Championship. Methods: A prospective study was carried out with the collection of data referring to injuries that occurred during the 2019 Brazilian Football Championship. The injuries were recorded by the responsible physician of each team, through an online injury mapping system. Results: Among the 645 athletes who were included in the study, 214 (33.2%) of the players had at least one injury during the tournament. In total, 257 injuries were recorded during the Brazilian Championship, with an average of 0.68 injuries per game. 59.1% of the injured athletes were over 26 years old. The most common type of injury was muscle strain (37.7%) and forwards were the most affected (33.6%). Conclusion: Muscle injuries were the most frequent in the tournament, with the thigh muscles being the most affected. Most of the affected players were over 26 years old, there were 20.5 injuries for every 1000 hours of play and the incidence of injuries was approximately 33%, with attackers being the most affected (33.6%). Level of Evidence III, Study of nonconsecutive patients; without consistently applied reference “gold” standard.

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