scholarly journals The analysis report of surgical treatment of limb deformity and disability: 35,075 cases

2021 ◽  
Vol 27 (3) ◽  
pp. 331-336
Author(s):  
J. Zang ◽  
◽  
S. Qin ◽  
◽  
◽  
...  
Keyword(s):  
Achilles Tendon ◽  
Central Government ◽  
Regional Distribution ◽  
Population Characteristics ◽  
Congenital Talipes Equinovarus ◽  
Limb Deformity ◽  
Tendon Lengthening ◽  
Surgical Methods ◽  
Talipes Equinovarus ◽  
Limb Deformities

Objective To investigate the incidence characteristics and corrective strategies of various limb deformities treated by Qinsihe orthopaedic team in the past 40 years, so as to provide a large sample for understanding the causes, types and treatment methods of limb deformity and disability in China. Method A total of 35,075 cases were treated by Qinsihe orthopaedic team from May 1978 to December 2018. The age, gender, deformity characteristics, etiological and pathological composition, regional distribution and surgical methods of the patients were statistically analyzed. Results There were 20,458 males and 14,617 females. The age was 1 year to 82 years old, average 20.5 years. The majority of subjects were from 11 to 25 years old or 19,363 cases (63 %). There were 33,259 cases (94.82 %) of interventions on lower extremity. The geographical distribution of patients covers all the provinces, municipalities directly under the central government, autonomous regions in China and 12 foreign countries. There were 202 etiologies involving neurological, heredity, metabolism, traumatic sequelae, congenital, vascular, lymphoid, skin, endocrine, iatrogenic and so on. The top six deformities were due to poliomyelitis sequelae, cerebral palsy, traumatic sequelae, spondylolysis sequelae, genu varus&valgus, congenital talipes equinovarus. There were 280 kinds of surgical methods, the majority of which were Achilles tendon lengthening, supracondylar osteotomy, subtalar joint arthrodesis, tibiofibular osteotomy, metatarsal aponeurosis and Achilles tendon replacement of peroneal longus muscle, etc. 8,702 cases were treated by orthopedic surgery combined with external fixation, including the Ilizarov fixator in 3,696 cases and hybrid fixator in 5,006 cases. Conclusion Qinsihe orthopaedic database with a history of 40 years is the largest one of limb deformity and disability in China. It reflects the etiology, type, population characteristics, surgical methods and strategy of limb disability and deformity, which can be treated by orthopaedic surgery. The data is a great treasure for orthopaedics and disability medicine in China and worldwide, and its important academic value and historical significance need to be further excavated and deep studied in future.

scholarly journals Lengthening of Achilles Tendon from the Percutaneous Tenotomy Procedure in Ponseti’s Method

2020 ◽  
Author(s):  
Yen Chang Lin ◽  
Wei Ning Chang ◽  
Yu Cheng Lai
Keyword(s):  
Achilles Tendon ◽  
Pearson Correlation ◽  
Ponseti Method ◽  
Lateral View ◽  
Foot Length ◽  
Tendon Lengthening ◽  
Radiographic Measurements ◽  
Talipes Equinovarus ◽  
Before And After ◽  
Percutaneous Tenotomy

Abstract Background Talipes equinovarus is one of the common congenital disease of foot deformity of newborn. Initial treatment is often with the Ponseti method. Studies have demonstrated that radiographic measurements can be made with clubfoot. The purposes of this study were to document the amount of Achilles tendon lengthening obtained from PAT in Ponseti’s method and to analyze the factors that might impact on the amount of equinus correction. Methods This is a retrospective study carried out from 2002 to 2006. Sixteen feet of twelve children that received percutaneous Achilles tendon tenotomy (PAT) for the treatment of congenital clubfoot were included. Assessments before and after treatment were performed using Dimeglio system. The foot length from toe to heel at the time of PAT, the pre- and post-PAT ankle dorsiflexion and post-casting lateral view of foot were obtained. The Pearson correlation coefficient was used to establish relationships between pre-, post-PATT and post-casting Tibio-calcaneal angle (TCA) and Achilles tendon length(ATL).Results The TCA before, after PATT, and after casting were -9.3, 27.4 and 18.4degrees. The ATL before, after PATT, and after casting were 22.7, 31.3, and 28.3mm. The overall lengthening of Achilles tendon was 5.7% of the foot length. The pre-PATT TCA was correlated with post-PATT and post-casting TCA. The pre-PATT ATL was correlated with post-PATT ATL and post-casting ATL.Conclusion Post-PAT correction effect is negatively correlated with the pre-PAT severity of equinus. The comparison between post-PAT and post-casting TCA could be used to check the quality of casting in the Ponseti method.Level of Evidence: level IV

scholarly journals Clubfoot: current concept of treatment

2021 ◽  
Vol 27 (4) ◽  
pp. 431-434
Author(s):  
A. Andreacchio ◽  
◽  
F. Alberghina ◽  
S. Monforte ◽  
A. Dimeglio ◽  
...  
Keyword(s):  
Current Knowledge ◽  
Ponseti Method ◽  
Idiopathic Clubfoot ◽  
Invasive Treatment ◽  
Congenital Talipes Equinovarus ◽  
Treatment Techniques ◽  
Talipes Equinovarus ◽  
Limb Deformities ◽  
Paediatric Orthopaedic

Introduction Idiopathic clubfoot (IC), also referred to as congenital talipes equinovarus, is one of the most common lower limb deformities observed in newborns, leading to significant functional impairment when left untreated. Early minimally invasive treatment has been praised as one of the most successful practice of modern pediatric orthopedics. This review aims to report current knowledge and controversies about clubfoot treatment. Material and methods We describe the main trends in clubfoot managing, identifying peculiarities, difficulties and prognostic factors related to the treatment. Results Many treatment techniques either conservative, surgical or hybrid have been used over the past decades. Based on good and excellent results during long-term follow-up, Ponseti method has been globally accepted by paediatric orthopaedic surgeons as standard method of treatment. However, some other conservative methods are still widely applied in the clinical setting, such as the French Physical Therapy method. Adherence to the bracing protocol is critical for the long-term success of the treatment, being a better predictor for relapse than severity of the deformity at birth. Conclusions Taking care of the manipulation and casting details by trained professionals, together with enhancing the child and patents’ adherence to the brace, are essential for the success of conservative treatment. Surgery should be performed only when strictly needed, preferably on a “a la carte” approach.

scholarly journals Modified Percutaneous Achilles Tendon Lengthening by Triple Hemisection for Achilles Tendon Contracture

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Yangjing Lin ◽  
Jin Cao ◽  
Changgui Zhang ◽  
Liu Yang ◽  
Xiaojun Duan
Keyword(s):  
Achilles Tendon ◽  
Recurrence Rate ◽  
Operative Time ◽  
Achilles Tendon Rupture ◽  
Tendon Lengthening ◽  
Group A ◽  
Achilles Tendon Lengthening ◽  
The Mean ◽  
Group B

Background. Both percutaneous Achilles tendon lengthening by triple hemisection and the traditional open Z-lengthening are effective methods for Achilles tendon contracture. This study aims to evaluate the efficacy and safety of this new therapeutic method, which is based on the percutaneous sliding technique with three hemi-cuts in the tendon, as compared with the traditional open Z-lengthening. Methods. Retrospective analysis of the Achilles tendon contracture cases in our hospital between January 2010 and September 2016 was conducted. Twenty-five cases received percutaneous Achilles tendon lengthening (group A), and 30 patients who underwent open Z-lengthening during the same period were in the control group (group B). Operative time and hospital stay were statistically analyzed. Incision complication, equinus recurrence rate and Achilles tendon rupture morbidity were recorded. The function was assessed by American Orthopaedic Foot & Ankle Society (AOFAS) score. All cases in group A received Magnetic Resonance Imaging (MRI) of ankle preoperatively and in the follow-ups. Results. The mean follow-up period was 42.04 months in group A and 61.7 months in group B. The entire operative time and the mean hospitalization days were lower in group A than in group B. No incision and infection complication occurred in group A. The infection rate in group B was 3.3%. Equinus recurrence rate was 4% in group A and the equinus recurrence rate in group B was 21.4%. In group A, the mean AOFAS score increased from 64 ± 10.16 points preoperatively to 96.08 ± 3.17 at final follow-up, while the score in group B increased from 63.48 ± 6.2 points to 85.4 ± 10.3. MRI showed continuity of the Achilles tendon and homogeneous signal in group A. Conclusion. Modified surgery can significantly reduce the risk of Achilles tendon rupture, provide better balance in soft tissue strength between ankle dorsiflexion and ankle plantarflexion, helping to avoid recurrence of the deformity.

scholarly journals Interobserver Reliability of Pirani and Dimeglio Scores in the Clinical Evaluation of Idiopathic Congenital Clubfoot

Children ◽  
2021 ◽  
Vol 8 (8) ◽  
pp. 618
Author(s):  
Vito Pavone ◽  
Andrea Vescio ◽  
Annalisa Culmone ◽  
Alessia Caldaci ◽  
Piermario La Rosa ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Clinical Evaluation ◽  
Interobserver Reliability ◽  
Strongly Correlated ◽  
Congenital Talipes Equinovarus ◽  
Orthopaedic Surgeons ◽  
Careful Preparation ◽  
Talipes Equinovarus ◽  
Pediatric Orthopaedic ◽  
Paediatric Orthopaedic

Background: Dimeglio (DimS) and Pirani (PirS) scores are the most common scores used in congenital talipes equinovarus (CTEV) clinical practice. The aim of this study was to evaluate the interobserver reliability of these scores and how clinical practice can influence the clinical outcome of clubfoot through the DimS and Pirs. Methods: Fifty-four feet were assessed by six trained independent observers through the DimS and PirS: three consultants (OS), and three residents (RS) divided into three pediatric orthopaedic surgeons (PeO) and three non-pediatric orthopaedic surgeons (NPeO). Results: The PirS and DimS Scores were strongly correlated. In the same way, OS and RS, PirS, and DimS scores were strongly correlated, and the interobserver reliability ranked “good” in the comparison between PeO and NPeO. In fully trained paediatric orthopaedic surgeons, an “excellent” interobserver reliability was found but was only “good” in the NPeO cohort. Conclusions: In conclusion, after careful preparation, at least six months of observation of children with CTEV, PirS and DimS proved to be valid in terms of clinical evaluation. However, more experience with CTEV leads to a better clinical evaluation.

THE EVALUATION OF THE RESULTS OF NEGLECTED CLUBFOOT MANAGED BY PONSETI METHOD

2021 ◽  
pp. 23-25
Author(s):  
Nandram Saryam ◽  
Raja Yadav ◽  
Manish Rajpoot
Keyword(s):  
Ponseti Method ◽  
Effective Technique ◽  
Congenital Talipes Equinovarus ◽  
Medical College ◽  
Relapse Pattern ◽  
Study Results ◽  
Talipes Equinovarus ◽  
Gandhi Medical College ◽  
A Prospective Study ◽  
Foot Disorder

Background: Congenital talipes equinovarus is the most common congenital foot disorder. neglected of clubfoot deformity occurs after the treatment by Ponseti method .we evaluate the relapse pattern of clubfoot basis of bhasker et al then treat the patient by Ponseti technique. Methods: This is a Prospective study .We are conducting a clubfoot clinic since 2013 in Department of Orthopaedics Gandhi medical college Bhopal . We register all clubfoot patient at our clubfoot clinic on his/her rst visit. All the clubfeet assessed with Pirani scoring system on the initial presentation to our institution and treat by Ponseti method. During this study there were a total of 558 children with 713 idiopathic clubfeet registered at our clinic. A total of 80 neglected clubfeet in 56 children presenting with neglected clubfeet were included in our study. Results: We found that The neglected feet in our study is (80 feet out of 713 feet. The male patient is 38 (67.86%) and female patient is 18 (32.14%). Male were predominantly involved as compared to female.The post treatment Pirani score after relapse treatment is 0.40 Conclusion: Ponseti technique is a simple, effective, inexpensive method for treatment of clubfeet there is, no requirement of special setup with limited resources and less rate of recurrence/complication than the surgical treatment It has been concluded that Ponseti method is a effective technique to treat congenital idiopathic clubfeet with success rate is 94.65% in our study

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