scholarly journals The Evaluation of Deformity Correction in Idiopathic Clubfoot During Ponseti Casting Sessions: Two Scoring Methods Depicted Graphically

2021 ◽  
Vol 7 (2) ◽  
Keyword(s):  
Deformity Correction ◽  
Idiopathic Clubfoot ◽  
Scoring Methods ◽  
Treatment Results ◽  
Minimal Improvement ◽  
Full Correction

Background We graphically analyzed the correction of total Pirani and Dimeglio scores and their subcomponents at sequential casting sessions for children with idiopathic clubfeet. Methods Correction of scores at weekly sessions was represented graphically. The tenotomy effect was accounted for separately. We classified 1st to 3rd casts as early, 4th and 5th cast midlevel, and beyond 5 as final casts to describe casting treatment. Results A total of 88 clubfeet (34 bilateral) in 54 patients were studied. Both total Pirani and Dimeglio graphs were characterized by a steep fall in early casts; subsequent minimal improvement in midlevel and final casts; later marked correction with tenotomy. Equinus in both scores stood as the most resistant deformity, showed full correction only following tenotomy. Dimeglio graphs captured coupling of various foot motions better over early casts than Pirani graphs. Conclusions Both Pirani and Dimeglio scores can adequately guide caregivers to progressive deformity correction in clubfoot. Keywords: Clubfoot, CTEV, Pirani, Dimeglio, Scores, Graphs

scholarly journals Are bilateral idiopathic clubfeet more severe than unilateral feet? A severity and treatment analysis

2018 ◽  
Vol 26 (2) ◽  
pp. 230949901877236 ◽  
Author(s):  
Anil Agarwal ◽  
Nargesh Agrawal ◽  
Sitanshu Barik ◽  
Neeraj Gupta
Keyword(s):  
Treatment Outcomes ◽  
Deformity Correction ◽  
Idiopathic Clubfoot ◽  
Achilles Tenotomy ◽  
Female Patients ◽  
Bilateral Group ◽  
Pirani Score ◽  
The Mean ◽  
Treatment Analysis ◽  
Unilateral Group

Introduction: Evidences suggest that different subgroups of idiopathic clubfoot exist with differences in severity and treatment outcomes. This study compares the severity and treatment outcomes of unilateral and bilateral clubfoot. Material and methods: We retrospectively studied 161 patients (bilateral 66, unilateral 95) with primary idiopathic clubfeet to evaluate the differences in severity and treatment. The parameters analyzed were precasting Pirani score, number of casts required, pretenotomy Pirani score, pretenotomy dorsiflexion, rate of tenotomy, and post-tenotomy dorsiflexion achieved. A Pirani score of at least 5 was classified as very severe and 4.5 or less was classified as less severe. Results: There were 49=(74.24%) male and 17 (25.75%) female patients in the bilateral group and 76 (80%) male and 19 (20%) female patients in the unilateral group. Out of 95 unilateral patients, 34 were left sided (35.8%). Comparing severity, the mean precasting Pirani score in bilateral patients (5.4 ± 0.6) was statistically more than the unilateral patients (4.9 ± 0.7). The number of casts required was significantly more in bilateral feet compared to unilateral (bilateral 5.3 ± 1.7, unilateral 4.7 ± 1.7; p < 0.011). Achilles tenotomy was required in all feet. Post Ponseti treatment, the foot deformity correction achieved (pretenotomy Pirani score, pretenotomy, and post-tenotomy dorsiflexion) was statistically similar in both unilateral and bilateral feet. Conclusions: Idiopathic bilateral clubfoot was more severe than unilateral foot at initial presentation and required more number of corrective casts. Post Ponseti treatment, the deformity correction in bilateral foot was similar to unilateral foot.

scholarly journals Conservative Management of Idiopathic Clubfoot: Kite versus Ponseti Method

2009 ◽  
Vol 17 (1) ◽  
pp. 67-71 ◽  
Author(s):  
AV Sanghvi ◽  
VK Mittal
Keyword(s):  
Conservative Management ◽  
Ponseti Method ◽  
Ankle Dorsiflexion ◽  
Long Term Results ◽  
Idiopathic Clubfoot ◽  
Success Rates ◽  
Residual Deformity ◽  
Full Correction ◽  
Rapid Correction

Purpose. To compare the long-term results of the Kite and Ponseti methods of manipulation and casting for clubfoot. Methods. 42 patients (with 64 idiopathic clubfeet) were equally randomised to Kite or Ponseti treatments in the early weeks of life. 14 males and 7 females (34 clubfeet) were treated by the Kite method, whereas 13 males and 8 females (30 clubfeet) were treated by the Ponseti method. All the clubfeet were manipulated, casted, and followed up (for a mean of 3 years) by one experienced orthopaedic surgeon. The final results were compared. Results. The success rates for the Kite and Ponseti treatments were similar (79% vs 87%). With the Ponseti method, the number of casts was significantly fewer (7 vs 10); the duration of casting required to achieve full correction was significantly shorter (10 vs 13 weeks); the maximum ankle dorsiflexion achieved was significantly greater (12 vs 6 degrees); and the incidence of residual deformity and recurrence was slightly lower. Conclusion. The Ponseti method can achieve more rapid correction and ankle dorsiflexion with fewer casts, without weakening the Achilles tendon.

scholarly journals Auto Preservation and Use of Auto Rib at Two-Step Surgical Treatment of Spine Deformities

2016 ◽  
pp. 28-32
Author(s):  
S. V. Kolesov ◽  
M. L. Sazhnev ◽  
A. A. Snetkov ◽  
A. I. Kaz’Min
Keyword(s):  
Spinal Deformity ◽  
Deformity Correction ◽  
Spine Deformity ◽  
Fatty Tissue ◽  
Treatment Results ◽  
Surgical Interventions ◽  
Spine Deformities ◽  
Subcutaneous Fatty Tissue ◽  
Preservation Technique

The possibility of preservation and use of a resected rib for dorsal fusion at final correction of spinal deformity was studied. Treatment results for 80 patients aged 15 to 45 years, with severe spine deformity (scoliosis or kyphoscoliosis) were analyzed. In all patients two step surgical interventions was performed. Either transpedicular or hybrid (screws and sublaminar cerclage) fixation of the vertebral column were performed in 37 and 43 cases, respectively. After ventral release the resected ribs were stitched to subcutaneous fatty tissue and preserved until the time of final dorsal correction. The follow-up period made up 1 - 2 years. Fusion formation and autograft reconstruction was confirmed by radiologic methods. It was shown that rib auto preservation technique was a simple one, did not require special preservation conditions and allowed to preserve sufficient volume of autograft for final spinal deformity correction.

Variants of Spine Deformity Correction in Children with Idiopathic Scoliosis of Thoracic Localization

2012 ◽  
Vol 19 (3) ◽  
pp. 9-13
Author(s):  
S. V Vissarionov ◽  
D. N Kokushin ◽  
A. P Drozdetsky ◽  
S. M Belyanchikov
Keyword(s):  
Deformity Correction ◽  
Frontal Plane ◽  
Spine Deformity ◽  
3D Ct ◽  
Treatment Results ◽  
Dorsal Approach ◽  
Apical Vertebra ◽  
Vertebral Bone ◽  
Bone Structures ◽  
Main Arch

Treatment results for 24 patients (21 girls and 3 boys), aged 14—17 years, with idiopathic thoracic scoliosis are presented. In all cases right-side type of deformity was observed. The main arch of curvature ranged from 52° to 92° by Cobb. The operation was performed from dorsal approach with application of metallic devices with transpedicular supporting elements using 3D-CT navigation. Depending on anatomical and anthropometric peculiarities of vertebral bone structures within the curvature arch, two variants of surgical correction were applied. Correction of the first type was performed in 18 patients; second type of correction was applied in 6 children. Second type of deformity correction differed from the first one by the sequence of rods implantation relative to the sides of main arch and corrective maneuvers at deformity correction. In the first group postoperative deformity correction in frontal plane made up 92—99%, derotation correction of the apical vertebra from 72 to 94% versus 91—100% and from 11,4 to 29,4% in the second group.

scholarly journals Change in the severity of congenital clubfoot in the first week of life

2020 ◽  
Vol 7 (4) ◽  
pp. 49-56
Author(s):  
Igor Yu. Kruglov ◽  
Nicolai Yu. Rumyantsev ◽  
Gamzat G. Omarov ◽  
Natalia N. Rumiantceva
Keyword(s):  
Deformity Correction ◽  
Varus Deformity ◽  
Foot Deformities ◽  
Idiopathic Clubfoot ◽  
Study Group ◽  
Congenital Clubfoot ◽  
Initial Examination ◽  
Global Literature ◽  
Equinus Deformity ◽  
Receive Treatment

Backgrоund. Congenital clubfoot or congenital equino-cava-varus deformity of the feet is one of the most common pathologies of the musculoskeletal system in children. Numerous articles in global literature have been published about changes in clubfoot severity during treatment; however, there are very few reports on how the severity of foot deformities with congenital clubfoot changes during the first week of life in the absence of deformity correction. Aim. To analyze changes in the severity of congenital clubfoot in the first week of life without any treatment. Materials and methods. The study group included 28 newborns with idiopathic congenital clubfoot (a total of 40 feet). The severity of clubfoot was evaluated on days one and seven after birth using the Dimeglio and Pirani scores. Results. During the initial examination of the newborns on the first day of life, the clubfoot severity recorded on the Pirani score was between 2 to 3 points and between 9 to 15 points on the Dimeglio score. Thus, in the first seven days of life in all patients who did not receive treatment, there was a significant increase in the severity of the equino-cava-varus deformity of the feet (p 0.05). The results of this study confirm that the severity of congenital clubfoot increases in the first week of life. This necessitates the beginning of the correction of severe idiopathic clubfoot in the first days after birth. Conclusions. The severity of congenital clubfoot during the first week of life significantly increased in all feet studied (p 0.05: 2 higher than in the table). If left untreated in the first week after birth, the equinus deformity progresses followed by varus deformity, anterior forefoot reduction, and, to a lesser extent, rotation.

scholarly journals Assessment of Ponseti technique of manipulation and serial casting in idiopathic clubfoot

2019 ◽  
Vol 5 (2) ◽  
pp. 248
Author(s):  
Asif Hussain Khazi Syed ◽  
Kiran Kumar Koppolu Kanthi ◽  
Yakub Baroothu ◽  
Lalith Mohan Chodavarapu
Keyword(s):  
Treatment Protocol ◽  
Ponseti Method ◽  
Foot Deformities ◽  
Idiopathic Clubfoot ◽  
Congenital Talipes Equinovarus ◽  
Pirani Score ◽  
Serial Casting ◽  
Talipes Equinovarus ◽  
Full Correction ◽  
Time Of Presentation

<p class="abstract"><strong>Background:</strong> Congenital talipes equinovarus is one of the commonest congenital foot deformities. Ponseti technique of treatment of clubfoot has gained popularity in the last few decades. Feet treated by Ponseti technique are supple, flexible and pain free. We have treated congenital idiopathic clubfoot with Ponseti technique at our institute and present our results.</p><p class="abstract"><strong>Methods:</strong> Forty eight feet in thirty children with clubfoot were treated by Ponseti technique in our institute. The study was conducted from December 2013 to December 2015. Parents were counselled regarding treatment protocol and maintenance with bracing was closely monitored. Each child was followed up for a minimum of six months. Pirani score was used to objectively document progress of treatment.<strong></strong></p><p class="abstract"><strong>Results:</strong> The average number of casts required for complete correction was 6.6. 38% feet required tendoachilles tenotomy. Higher the initial Pirani score, more number of casts were required to achieve full correction. Number of casts needed for complete correction did not correlate to time of presentation.</p><p class="abstract"><strong>Conclusions:</strong> Ponseti method is very effective in correcting congenital idiopathic clubfoot deformity. It’s easy to learn, is inexpensive and can completely correct the deformity. In developing nations, well trained Orthopaedic surgeons can treat these children effectively and decrease disabled population.</p><p class="abstract"> </p>

scholarly journals THE POSSIBILITIES OF EXTERNAL TRANSPEDICULAR FIXATOR IN SPINE DEFORMITY CORRECTION

2005 ◽  
pp. 020-024
Author(s):  
Aleksandr Timofeyevich Khudyaev ◽  
Oksana Germanovna Prudnikova ◽  
Ivanna Aleksandrovna Mescheriagina ◽  
Yulia Antonocna Mushtaeva
Keyword(s):  
Neurological Disorders ◽  
Deformity Correction ◽  
Spine Deformity ◽  
Spine Biomechanics ◽  
Treatment Results ◽  
Deformation Degree ◽  
Clinical Control ◽  
Spine Deformities ◽  
Short Time ◽  
Deformation Correction

Objective. To define the most effective assemblies of external transpedicular fixator for correction of kyphotic and scoliotic deformities of the spine. Material and Methods. Treatment results in 108 adolescents with different kinds of III–IV degree scoliosis and kyphosis were studied. The spine deformation degree was assessed in accordance with V.D. Chaklin’ classification. Neurological examination have shown the absence of major neurological disorders. Deformation correction was performed with device consisting of transpedicular rods which were fixed to anchorage plates and coupled into support bases. Results. The application of the fixator with additional lateral traction is optimal to correct C-shaped scoliosis and the frame with damping device allows correcting the curvatures of S-shaped deformities within a short time, in some cases even hypercorrection can be achieved. The application of additional fixing rod is fruitful in kyphosis correction. Conclusion. The application of the external transpedicular fixator under radiological and clinical control allows the correction of various spine deformities without neurological deficit with the account of spine biomechanics.

scholarly journals Auto Preservation and Use of Auto Rib at Two-Step Surgical Treatment of Spine Deformities

2016 ◽  
Vol 23 (3) ◽  
pp. 28-32
Author(s):  
S. V Kolesov ◽  
M. L Sazhnev ◽  
A. A Snetkov ◽  
A. I Kaz’min
Keyword(s):  
Spinal Deformity ◽  
Deformity Correction ◽  
Spine Deformity ◽  
Fatty Tissue ◽  
Treatment Results ◽  
Surgical Interventions ◽  
Spine Deformities ◽  
Subcutaneous Fatty Tissue ◽  
Preservation Technique

The possibility of preservation and use of a resected rib for dorsal fusion at final correction of spinal deformity was studied. Treatment results for 80 patients aged 15 to 45 years, with severe spine deformity (scoliosis or kyphoscoliosis) were analyzed. In all patients two step surgical interventions was performed. Either transpedicular or hybrid (screws and sublaminar cerclage) fixation of the vertebral column were performed in 37 and 43 cases, respectively. After ventral release the resected ribs were stitched to subcutaneous fatty tissue and preserved until the time of final dorsal correction. The follow-up period made up 1 - 2 years. Fusion formation and autograft reconstruction was confirmed by radiologic methods. It was shown that rib auto preservation technique was a simple one, did not require special preservation conditions and allowed to preserve sufficient volume of autograft for final spinal deformity correction.

scholarly journals Utility of the MISDEF2 Algorithm and Extent of Fusion in Open Adult Spinal Deformity Surgery With Minimum 2-Year Follow-up

Neurospine ◽  
2021 ◽  
Vol 18 (4) ◽  
pp. 824-832
Author(s):  
Bo Li ◽  
Gregory Hawryluk ◽  
Praveen V. Mummaneni ◽  
Michael Wang ◽  
Ratnesh Mehra ◽  
...  
Keyword(s):  
Spinal Deformity ◽  
Adult Spinal Deformity ◽  
Deformity Correction ◽  
Class Ii ◽  
Class I ◽  
Complication Rates ◽  
Class Iii ◽  
Full Correction ◽  
Class Iv

Objective: Long-segment fusion in adult spinal deformity (ASD) is often needed, but more focal surgeries may provide significant relief with less morbidity. The minimally invasive spinal deformity surgery (MISDEF2) algorithm guides minimally invasive ASD surgery, but it may be useful in open ASD surgery. We classified ASD patients undergoing focal decompression, limited decompression and fusion, and full correction according to MISDEF2 and correlated outcomes.Methods: A retrospective study of ASD patients treated by 2 surgeons at our hospital was performed. Inclusion criteria were: age > 50, minimum 2-year follow-up, and open ASD surgery. Tumor, trauma, and infections were excluded. Patients had open surgery including focal decompression, short segment fusion, or full scoliosis correction. All patients were categorized by MISDEF2 into 4 classes based upon spinopelvic parameters. Perioperative metrics were assessed. Radiographic correction, complications and reoperation were recorded.Results: A total of 136 patients met inclusion criteria. Mean follow-up was 46 ± 15.8 months (range, 24–118 months). Forty-seven underwent full deformity correction, 71 underwent short segment fusion, and 18 underwent decompression alone. There were 24 cases of class I, 66 cases of class II, 23 cases of class III, and 23 cases of class IV patients. Patients in class I and II had perioperative complication rates of 0% and 16.7% and revision rates of 8% and 21.2% when undergoing focal decompression or limited fusion. However, class II patients undergoing full correction had higher perioperative complications rate (p = 0.03) and revision surgery rates (p = 0.047). This difference was not seen in class III patients (p > 0.05). All class IV patients underwent full correction, but they had higher perioperative complication rates (p < 0.019), comparable revision surgery rates (p = 0.27), and better radiographic realignment (p < 0.001). In addition, full deformity correction was associated with longer length of stay, increased blood loss, and longer operative time (p < 0.001).Conclusion: The MISDEF2 algorithm may help guide ASD surgical decision making even in open surgery, with focal treatment used in class I and II patients as a viable alternative and full correction implemented in class IV patients because of severe malalignment. However, class II patients with ASD undergoing full deformity correction do have higher complication rates.

Sign in / Sign up

Export Citation Format

Share Document