4,507 results match your criteria Clubfoot


What is the optimal treatment for equinus deformity in walking-age children with clubfoot? A systematic review.

EFORT Open Rev 2021 May 4;6(5):354-363. Epub 2021 May 4.

St George's University Hospitals NHS Foundation Trust, London, UK.

Equinus contracture is the most common deformity at clubfoot relapse and causes pain and functional limitation. It presents a challenge to the orthopaedic surgeon throughout childhood.A systematic review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Read More

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Evaluation of a surgical treatment algorithm for neglected clubfoot in low-resource settings.

Int Orthop 2021 Jun 19. Epub 2021 Jun 19.

Impact Foundation Bangladesh, Dhaka, Bangladesh.

Purpose: Idiopathic clubfoot affects approximately 1/1000 alive-born infants, of whom 80-91% are born in low- or middle-income countries (LMICs). This retrospective study aimed to evaluate the morphological, functional, and social outcomes in patients with neglected clubfoot in rural Bangladesh, after receiving surgical treatment.

Methods: Patients received a posteromedial release (PMR) with or without an additional soft tissue intervention (group 1), a PMR with an additional bony intervention (group 2), or a triple arthrodesis (group 3) according to our surgical algorithm. Read More

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Neglected neurogenic clubfoot treated with Achilles tendon lengthening using Z-plasty, total talectomy, and tibiocalcaneal arthrodesis.

Int J Surg Case Rep 2021 Jun 2;84:106051. Epub 2021 Jun 2.

Department of Orthopaedic and Traumatology, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo National Central General Hospital, Jakarta, Indonesia. Electronic address:

Introduction: The most common foot and ankle deformity from injury to the nervous system is equinocavovarus. This deformity comprises of equinus, cavus, varus, and adduction of the forefoot which leads to pain and poor stability in stance phase of gait. Treatment for this condition is difficult regarding literature limitation of the neurogenic clubfoot management. Read More

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Ponseti Casting vs. Soft Tissue Release for the Initial Treatment of Non-idiopathic Clubfoot.

Front Surg 2021 28;8:668334. Epub 2021 May 28.

Department of Orthopaedic Surgery, Texas Tech University Health Science Center, Lubbock, TX, United States.

Ponseti casting has universally been accepted as the gold standard for treatment of idiopathic clubfoot. Conversely, primary treatment for non-idiopathic clubfoot has not been established. The purpose of this study is to compare treatment outcomes following primary soft tissue release (STR) and Ponseti casting of non-idiopathic clubfoot. Read More

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Treatment of Relapsed and Neglected Pes Equinovarus with Binary Arthrodesis and Hexapodal Spider Frame.

Indian J Orthop 2021 May 17;55(Suppl 1):128-134. Epub 2020 Aug 17.

Clinic of Orthopaedics and Traumatology, Private Memorial Hospital, Kayseri, Turkey.

Purpose: The aim of this study was to assess the clinical and radiological outcomes of patients with recurrent or neglected pes equinovarus (PEV), who underwent talonavicular or calcaneocuboid arthrodesis with a hexapod spider frame.

Methods: The study included 18 patients; a total of 25 feet were treated with dual arthrodesis and a hexapod spider frame. The International Club Foot Study Group (ICFSG) scoring system and visual analog scale (VAS) were used to assess preoperative status and postoperative outcomes. Read More

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The foot external rotation above-knee (FERAK) brace versus the Denis Browne brace for management of idiopathic clubfoot following Ponseti casting: a randomized controlled trial.

Int Orthop 2021 Jun 13. Epub 2021 Jun 13.

Department of Orthopaedic Surgery, Faculty of Medicine, Cairo University, Cairo, Egypt.

Purpose: To compare the foot external rotation above-knee (FERAK) brace and the Denis Browne boot (DBB) brace in terms of relapse prevention and parents' compliance after successful correction with Ponseti casting.

Methods: A single-centre, randomized controlled study was conducted between 2016 and 2020. A total of 60 feet in 38 patients with idiopathic clubfoot initially corrected with the Ponseti method were included. Read More

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Is the modified Ponseti method effective in treating atypical and complex clubfoot? A systematic review.

Int Orthop 2021 Jun 10. Epub 2021 Jun 10.

Department of Orthopedic Surgery, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.

Purpose: In 2006, Ponseti modified the standard technique to treat cases of "atypical" and "complex" clubfoot. To determine the outcomes of Ponseti's modified method to treat complex idiopathic clubfoot patients, we asked the following: (1) What is the deformity correction success rate? (2) What is the relapse rate after the correction? (3) What is the incidence of complications?

Materials And Methods: We performed a systematic review by searching the EMBASE, MEDLINE, Cochrane Library, and Web of Science databases from inception to March 1, 2021. All studies on idiopathic, complex, and atypical clubfoot that assessed Ponseti's modified technique were included. Read More

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Plantar load transfer in children: a descriptive study with two pathological case studies.

BMC Musculoskelet Disord 2021 Jun 7;22(1):521. Epub 2021 Jun 7.

School of Allied Health Sciences, Griffith University, Gold Coast, QLD, 4222, Australia.

Background: Typical gait is often considered to be highly symmetrical, with gait asymmetries typically associated with pathological gait. Whilst gait symmetry is often expressed in symmetry ratios, measures of symmetry do not provide insight into how these asymmetries affect gait variables. To fully understand changes caused by gait asymmetry, we must first develop a normative database for comparison. Read More

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A Foot to Last a Lifetime-Is Hindfoot Fusion Ever Appropriate for Pediatric Orthopaedic Conditions?

Authors:
Derek M Kelly

J Pediatr Orthop 2021 Jul;41(Suppl 1):S39-S46

Campbell Clinic Orthopaedics, Memphis, TN.

Introduction: Hindfoot deformities in the pediatric population can be painful and result in severe limitations. Although arthrodesis is known to relieve pain, there are concerns over its use because of the risk that adjacent joint degenerative disease could result, leading to a new source of pain, dysfunction, and additional surgical procedures later in life.

Methods: A literature review of hindfoot fusions in children focused on articles with the highest levels of evidence and those of particular historical significance. Read More

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Maternal periconceptional folic acid supplements use and fetus risk for limb defects.

Paediatr Perinat Epidemiol 2021 May 31. Epub 2021 May 31.

Institute of Reproductive and Child Health, Peking University/ National Health Commission Key Laboratory, Peking University, Beijing, China.

Background: Associations between the periconceptional folic acid only (FAO) or multiple micronutrients containing folic acid (MMFA) supplementation and risk for limb defects are inconsistent.

Objective: To explore the association between periconceptional folic acid supplements use and risk for limb defects, including clubfoot, polydactyly, syndactyly, and limb deficiencies.

Methods: Data were derived from a cohort based on a pregnancy registry in a district of Beijing, China, from 2013 to 2018. Read More

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Functional dystonia in the foot and ankle.

Bone Joint J 2021 Jun;103-B(6):1127-1132

Foot and Ankle Unit, The Royal National Orthopaedic Hospital, London, UK.

Aims: To assess the characteristic clinical features, management, and outcome of patients who present to orthopaedic surgeons with functional dystonia affecting the foot and ankle.

Methods: We carried out a retrospective search of our records from 2000 to 2019 of patients seen in our adult tertiary referral foot and ankle unit with a diagnosis of functional dystonia.

Results: A total of 29 patients were seen. Read More

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Development of foot length in children with congenital clubfoot up to 7 years of age: a prospective follow-up study.

BMC Musculoskelet Disord 2021 May 27;22(1):487. Epub 2021 May 27.

Department of Clinical Sciences, Lund University, Orthopedics, 221 85, Lund, Sweden.

Background: Clubfeet are typically shorter than normal feet. This study aimed first to describe the development of foot length in a consecutive series of children with congenital clubfoot and second to relate foot length to development of relapse and motion quality.

Methods: Foot length was measured every 6 months in 72 consecutive children with congenital clubfoot (29 bilateral) aged from 2 to 7 years. Read More

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TARP syndrome associated with renal malformation and optic nerve atrophy.

BMJ Case Rep 2021 May 24;14(5). Epub 2021 May 24.

Department of Pediatrics at Fundación Santa Fé de Bogotá, Hospital Universitario de la Fundacion Santa Fe de Bogota, Bogota, Colombia.

Talipes equinovarus, atrial septal defect, Robin sequence and persistent left superior vena cava (TARP) syndrome is a congenital disease caused by mutations in the RBBM10 gene. It has a low prevalence and a high rate of mortality in the neonatal stage. In this case report, we present a case of a 32-week gestational age preterm newborn with a prenatal diagnosis of intrauterine growth restriction, with a persistent left superior vena cava, interatrial communication and a horseshoe kidney. Read More

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Relapses in clubfoot treated with Ponseti technique and standard bracing protocol- a systematic analysis.

J Clin Orthop Trauma 2021 Jul 2;18:199-204. Epub 2021 May 2.

Department of Paediatric Orthopaedics, Chacha Nehru Bal Chikitsalaya, Geeta Colony, Delhi, 31, India.

Purpose: The analysis determined the relapses in clubfoot children treated with Ponseti technique and standard bracing protocol and their correlation with overall follow up duration using pooled data from various series. It also tested the prescribed timelines of 5 and 7 years for slow-down/cessation of relapses in clubfoot children.

Methods: A systematic literature search was performed for articles published in "Pubmed (includes Medline indexed journals)" electronic databases using key words: "Clubfoot or CTEV or congenital talipes equinovarus", "Ponseti" for years 1 January 2001 to 15 November 2020. Read More

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Idiopathic clubfoot treatment and heterogeneity of current therapeutic strategies: The Ponseti method versus the French functional method (a systematic review).

Arch Pediatr 2021 Jul 19;28(5):422-428. Epub 2021 May 19.

2, rue Jean-Suau, 31000 Toulouse, France.

Background: Since Hippocrates, the treatment of idiopathic clubfoot has undergone many changes, with surgical techniques and conservative approaches evolving over the centuries. Today, a wide variety of practices exist in France and throughout the world; consequently, the treatment of idiopathic clubfoot remains controversial, but the Ponseti method and the functional method seem to stand out. Nevertheless, has one of them demonstrated superiority?

Methods: The purpose of this review is to compare these two methods. Read More

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Magnetic resonance imaging of severe idiopathic club foot treated with one-week accelerated Ponseti (OWAP) technique.

Foot Ankle Surg 2021 May 12. Epub 2021 May 12.

Annajah Medical School, Palestine. Electronic address:

Purpose: This study aims to evaluate changes in tarsal bones relationship after the use of one week accelerated Ponseti method in the treatment of severe idiopathic clubfoot using MRI. We hypothesize that one-week accelerated Ponseti is at least as effective as standard techniques in achieving the desirable MRI parameters.

Methods: This is a prospective study of 8 children with severe idiopathic clubfeet (Pirani 6) (4 unilateral and 4 bilateral) treated before the age of three months with one-week accelerated Ponseti technique, as described in a former study with minimum 2-year follow-up. Read More

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A Patient with a Type I Split Cord Malformation and an Open Myelomeningocele without Advanced Lower Limb Paresis: A Case Report and a Review of the Literature.

NMC Case Rep J 2021 Apr 2;8(1):75-78. Epub 2021 Apr 2.

Department of Neurosurgery, Yamagata University, Faculty of Medicine, Yamagata, Yamagata, Japan.

We report a rare case of a split cord malformation (SCM) combined with an open myelomeningocele (MMC) on the right hemicord. The patient was a male neonate, who exhibited an MMC in the lumbosacral region at birth. Both of his lower limbs moved with slight spasticity, but no atrophic changes or clubfoot deformities were seen. Read More

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Sequential Bilateral Achilles Tendon Rupture in a Teenager After Ponseti Treatment for Bilateral Clubfoot: A Case Report.

JBJS Case Connect 2021 05 18;11(2). Epub 2021 May 18.

Department of Orthopaedic Surgery, University of Colorado and Children's Hospital Colorado, Aurora, Colorado.

Case: Our patient was born with bilateral congenital clubfeet and underwent standard Ponseti treatment. At 8 months of age, bilateral percutaneous Achilles tenotomies were performed, with an excellent outcome. At 16 years, he suffered a unilateral Achilles tendon rupture, and at 18 years, he suffered a contralateral Achilles rupture, both of which were successfully repaired. Read More

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Genetic and congenital disorders in pre-Hispanic Moche pottery.

Am J Med Genet C Semin Med Genet 2021 06 13;187(2):269-277. Epub 2021 May 13.

Archeological Museum Julio César Cubillos, Archeodiversity Research, Universidad del Valle, Cali, Colombia.

The Moche were a pre-Hispanic, pre-Incan people who inhabited northwestern Peru from 50 to 850 AD and left behind a large body of ceramic artwork. We present 26 pieces from 5 museums, which seem to show individuals with malformations, minor anomalies, and possible genetic syndromes. Possible diagnoses include cleft lip and palate, ocular anomalies such as hypertelorism and orbital dystopia, oligo- and polydactyly, conjoined twinning, clubfoot, Down syndrome, Crouzon syndrome, and Seckel syndrome. Read More

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The Clubfoot, Le Pied-Bot.

Authors:
Judith G Hall

Am J Med Genet C Semin Med Genet 2021 06 12;187(2):160-162. Epub 2021 May 12.

Department of Pediatrics and Medical Genetics, British Columbia Children's Hospital, University of British Columbia and Children's and Women's Health Centre of British Columbia, Vancouver, British Columbia, Canada.

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Limb body wall complex complicating a dichorionic diamniotic twin pregnancy: MRI for demonstration of fetal morphology.

BMJ Case Rep 2021 May 12;14(5). Epub 2021 May 12.

Department of Radiodiagnosis, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, Pondicherry, India.

Limb body wall complex (LBWC) is a rare, lethal malformation characterised by body wall defects, craniofacial and limb anomalies with or without various other organ anomalies. We report a case of dichorionic diamniotic twin pregnancy discordant for LBWC, diagnosed by ultrasound (US) and confirmed by MRI at 21 weeks' gestation, managed expectantly and delivered at 35 weeks by emergency caesarean section with a favourable outcome of the unaffected twin. The anomalous twin, who died soon after birth, had a sizeable thoracoabdominal wall defect, eviscerated liver and bowel loops attached to the placenta, short cord, ectopia cordis, lung hypoplasia, kyphoscoliosis, right upper limb amelia and left clubfoot with polydactyly. Read More

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A novel and recurrent KLHL40 pathogenic variants in a Chinese family of multiple affected neonates with nemaline myopathy 8.

Mol Genet Genomic Med 2021 May 12:e1683. Epub 2021 May 12.

Genetic and Metabolic Central Laboratory, Birth Defect Prevention Research Institute, Maternal and Child Health Hospital, Children's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China.

Background: Nemaline myopathy 8 is a severe autosomal recessive muscle disorder characterized by fetal akinesia or hypokinesia, contractures, fractures, respiratory failure and swallowing difficulties apparent at birth.

Methods: An affected dizygotic twin pair from a non-consanguineous Chinese family presented with severe asphyxia, lethargy and no response to stimuli. The dysmorphic features included prominent nasal bridge, telecanthus, excessive hip abduction, limb edema, absent palmar and sole creases, acromelia, bilateral clubfoot, appendicular hypertonia and cryptorchidism. Read More

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Late Effects of Clubfoot Deformity in Adolescent and Young Adult Patients Whose Initial Treatment Was an Extensive Soft-tissue Release: Topic Review and Clinical Case Series.

J Am Acad Orthop Surg Glob Res Rev 2020 05;4(5):e1900126

From the Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, MO (Dr. Johnson, Dr. Klein, Dr. McCormick, Dr. Dobbs, Dr. Gordon, Dr. Schoenecker); the Department of Orthopaedic Surgery, Dartmouth-Hitchcock School of Medicine, New Hampshire, NH (Dr. Fortney); and the Congress Orthopaedic Associates, Arcadia, CA (Dr. Luk).

Children with congenital clubfoot often have residual deformity, pain, and limited function in adolescence and young adulthood. These patients represent a heterogeneous group that often requires an individualized management strategy. This article reviews the available literature on this topic while proposing a descriptive classification system based on a review of patients at our institution who underwent surgery for problems related to previous clubfoot deformity during the period between January 1999 and January 2012. Read More

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Infrared Thermal Imaging for Evaluation of Clubfoot After the Ponseti Casting Method-An Exploratory Study.

Front Pediatr 2021 20;9:595506. Epub 2021 Apr 20.

School of Biomedical Engineering, University of Technology Sydney, Sydney, NSW, Australia.

Conservative treatment, Ponseti method, has been considered as a standard method to correct the clubfoot deformity among Orthopedic society. Although the result of conservative methods have been reported with higher success rates than surgical methods, many more problems have been reported due to improper casting, casting pressure or bracing discomfort. Nowadays, infrared thermography (IRT) is widely used as a diagnostic tool to assess musculoskeletal disorders or injuries by detecting temperature abnormalities. Read More

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Ponseti Cast Removal: Video Technique.

J Orthop Case Rep 2020 May-Jun;10(3):50-52

Department of Paediatric Orthopaedics, Sancheti Institute for Orthopaedics and Rehabilitation, Pune, Maharashtra, India.

Introduction: Ponseti casting method is the gold standard for the management of congenital talipes equinovarus in neonates, which consists of weekly manipulation and serial casting. Using oscillatory saw for cast removal is user-dependant and has been fraught with complications consisting of saw burns, thermal abrasions, anxiety, and fear of the saw (especially in children). The aim of this article is to describe our technique of cast removal using visual media format. Read More

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Surgical Treatment of Clubfoot in Children with Moebius Syndrome.

Children (Basel) 2021 Apr 19;8(4). Epub 2021 Apr 19.

Pediatric Orthopedic and Traumatology Unit, San Raffaele Hospital, 20132 Milan, Italy.

Moebius syndrome (MS) is a rare disease, with paralysis of the VI and VII cranial nerves, frequently associated with clubfoot (CF). The aim of this study was to evaluate surgical treatment of CF in MS, providing its peculiarities. Between 1990 and 2019, we collected data of 11 MS patients with unilateral ( = 5) or bilateral ( = 6) CF, for a total of 17 feet (9R,8L). Read More

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Statistical shape modelling to analyse the talus in paediatric clubfoot.

Proc Inst Mech Eng H 2021 Apr 25:9544119211012115. Epub 2021 Apr 25.

Department of Mechanical Engineering, College of Engineering, University of Wisconsin Madison, Madison, WI, USA.

One fifth of idiopathic clubfoot deformities cannot be fully corrected by Serial Ponseti casting and deformity recurs in 20%-30% of cases. To avoid x-ray exposure, the joints with largely unossified bones are diagnosed with magnetic resonance images (MRI). Typically, geometric measurements are made in the MRI planes; however, this method is inaccurate compared to measurements on three-dimensional (3D) models of the joint. Read More

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Outcomes of Clubfoot Treated With Casting in Ghana.

Cureus 2021 Mar 22;13(3):e14046. Epub 2021 Mar 22.

Epidemiology and Public Health, Hope Walks, Mechanicsburg, USA.

Objective: Idiopathic clubfoot deformity is a condition in pediatric orthopedics with a prevalence of 1 in 1000. This study reports the outcomes of clubfoot treatment in Ghana.

Methods: The study was Institutional Review Board (IRB) approved. Read More

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Development of a functional prototype of a SMART (Sensor-integrated for Monitoring And Remote Tracking) foot abduction brace for clubfoot treatment: a pre-clinical evaluation.

Int Orthop 2021 Apr 22. Epub 2021 Apr 22.

Department of Mechanical Engineering, Indian Institute of Technology-Bombay (IIT-B), Mumbai, India.

Purpose: Recurrences following clubfoot correction by the Ponseti method can be prevented by regular use of a foot abduction brace (FAB) until the child is four to five years old. However, there is a lack of an objective method to measure actual hours of brace usage. The aim was to develop a functional prototype of a SMART (Sensor-integrated for Monitoring And Remote Tracking) clubfoot brace to record accurate brace usage and transmit the data remotely to healthcare providers treating clubfoot. Read More

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Development of a core outcome set for idiopathic clubfoot management.

Bone Jt Open 2021 Apr;2(4):255-260

St George's Healthcare NHS Trust, London, UK.

Aims: This study aims to define a set of core outcomes (COS) to allow consistent reporting in order to compare results and assist in treatment decisions for idiopathic clubfoot.

Methods: A list of outcomes will be obtained in a three-stage process from the literature and from key stakeholders (patients, parents, surgeons, and healthcare professionals). Important outcomes for patients and parents will be collected from a group of children with idiopathic clubfoot and their parents through questionnaires and interviews. Read More

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