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Is it Possible to Treat Recurrent Clubfoot with the Ponseti Technique After Posteromedial Release?: A Preliminary Study

Authors
  • Nogueira, Monica Paschoal1,
  • Ey Batlle, Anna Maria2
  • Alves, Cristina Gomes3
  • 1 Hospital do Servidor Público Estadual, Pediatric Orthopaedic Group, Orthopaedics Department, São Paulo, Brazil , São Paulo (Brazil)
  • 2 Hospital Sant Joan de Deu, Orthopaedics Department, Barcelona, Spain , Barcelona (Spain)
  • 3 Hospital Central do Funchal, Orthopaedics Department, Funchal, Madeira, Portugal , Funchal (Portugal)
Type
Published Article
Journal
Clinical Orthopaedics and Related Research
Publisher
Ovid Technologies (Wolters Kluwer) - Lippincott Williams & Wilkins
Publication Date
Feb 04, 2009
Volume
467
Issue
5
Pages
1298–1305
Identifiers
DOI: 10.1007/s11999-009-0718-9
Source
Springer Nature
Keywords
License
Yellow

Abstract

The Ponseti technique for treating clubfoot has been popularized for idiopathic clubfoot and more recently several syndromic causes of clubfoot. We asked whether it could be used to treat recurrent clubfoot following failed posteromedial release. We retrospectively reviewed 58 children (83 clubfeet) treated by the Ponseti technique for recurrent deformity after posteromedial release in three centers. The minimum followup was 24 months (average, 45 months; range, 24–80 months). We determined initial and final Pirani scores and range of motion of the ankle and subtalar joint. Plantigrade and fully corrected feet were obtained in 71 feet (86%); 11 feet obtained partial correction; one patient failed treatment and underwent another posteromedial release. Recurrences occurred in nine patients (12 feet or 14%). Initial Pirani scores improved in all but one patient; severity of deformity was also inferred by number of casts used for treatment. The age at treatment and numbers of casts did not influence the scores of Pirani et al. The scores were similar among the three orthopaedic surgeons. Level of Evidence: Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

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