Treatment of the idiopathic and complex congenital talipes equinovarus with Ponseti method

  • Lovro Suhodolčan Ukc Ljubljana, Ortopedska klinika, Zaloška 9, 1000 Ljubljana
  • Karin Schara Ukc Ljubljana, Ortopedska klinika, Zaloška 9, 1000 Ljubljana
  • Janez Brecelj Ukc Ljubljana, Ortopedska klinika, Zaloška 9, 1000 Ljubljana
  • Vane Antolič Ukc Ljubljana, Ortopedska klinika, Zaloška 9, 1000 Ljubljana
Keywords: Congenital idiopathic talipes equinovarus, Clubfoot, Complex, atypic, Ponseti method

Abstract

Abstract:

Congenital idiopathic clubfoot is a deformity typically occurring in an otherwise healthy child which occurs in 11,4 in 10.000 live births. Approximately one-half of cases present with bilateral deformity and affects boys and girls equally. Clubfoot is characterized by adduction, supination and cavus deformity of the forefoot and midfoot, varus of the heel, and a fixed plantar flexion (equinus) of the ankle. Treatment od idiopathic type of clubfoot consists of corrective manipulation and casting by the Ponseti method, where usually four to six casts are needed. Equinus is corrected with tendo Achillis tenotomy followed by foot abduction brace application.

Complex type of clubfoot, which has more severe rigid deformation, is present in 6,5% of all clubfeet and is refractory to the usual corrective manipulation and casting by the Ponsetti method. Clinically, complex clubfoot is characterized  as short, stubby foot,  having rigid equinus, severe adduction and plantar flexion of all metatarsals, a deep crease above the heel and a transverse crease in the sole of the foot. Modified Ponsetti method for treatment of complex clubfoot consists of simultaneus correction of adduction and heel varus and subsequent cavus and rigid equinus correction. After the Achillis tendon tenotomy, modified foot abduction brace is applied, where foot is in 40° outer rotation in contrast to 70° abduction used in less rigid congenital idiopathic clubfoot. Relapse occurs in 14% and is ussually related to problems with shoe fit and patient coplience.

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Author Biographies

Lovro Suhodolčan, Ukc Ljubljana, Ortopedska klinika, Zaloška 9, 1000 Ljubljana
asist. dr, specializant ortopedske kirurgije
Karin Schara, Ukc Ljubljana, Ortopedska klinika, Zaloška 9, 1000 Ljubljana
Ortopedska klinika, otroški oddelek, specialist, mag.
Janez Brecelj, Ukc Ljubljana, Ortopedska klinika, Zaloška 9, 1000 Ljubljana
Ortopedska klinika, otroški oddelek, specialist, vodja oddelka, doc. dr.
Vane Antolič, Ukc Ljubljana, Ortopedska klinika, Zaloška 9, 1000 Ljubljana
Oropedska klinika, predstojnik, prof. dr., višji svetnik

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Published
2015-10-19
How to Cite
1.
Suhodolčan L, Schara K, Brecelj J, Antolič V. Treatment of the idiopathic and complex congenital talipes equinovarus with Ponseti method. ZdravVestn [Internet]. 19Oct.2015 [cited 26Jun.2019];84(10). Available from: https://vestnik.szd.si/index.php/ZdravVest/article/view/1002
Section
Review