Acta Scientific Orthopaedics (ISSN: 2581-8635)

Research Article Volume 6 Issue 3

Radiographic Evaluation of Patients Undergoing Treatment of Idiopathic Clubfoot by the Ponseti Method

Antonio Luiz Gonçalves Brandão*, Bruno Gil de Carvalho Lima, Guillermo Oscar Hernández Tierno, Milena Oliveira Silva Cruz and Monica Paschoal Nogueira

Sister Dulce Social Works (OSID), Salvador, BA, Brazil

*Corresponding Author: Antonio Luiz Gonçalves Brandão, Sister Dulce Social Works (OSID), Salvador, BA, Brazil.

Received: December 19, 2022; Published: February 02, 2023

Abstract

Background: Idiopathic clubfoot is the most common congenital deformity of the foot and the Ponseti method has been widely used as the of choice for treatment. Your treatment should be started early in life, in spite of feet treated late reports that are increasing in the literature. The evaluation method is clinical and based on the clinical appearance and function and requires tests to prove the good found in these assessments.

Objective: Evaluate the radiograph as a method of measuring effectiveness of Ponseti method for the treatment of unilateral congenital clubfeet using plain radiography.

Methods: We conducted a retrospective study from medical record data on patients with congenital idiopathic unilateral clubfoot, with ages ranging from 48 to 177 months. Patients underwent radiographs in anteroposterior and lateral view, in weight bearing and angles were traced to measure the relationship between the tarsal bones of the middle and hind foot of the treaty and normal.

Results: The final average Pirani score was 0.35. Statistical analysis showed that the calcaneal-fifth metatarsal angle on the anteroposterior view, tibial-calcaneal and the horizontal-calcaneus in lateral view, also showed when subjected to the comparison test similarity, with p values > 0.05. Other angles did not show statistical similarity when compared with the foot control (p < 0.01). All angles were within the normal range when compared to literature data. There was no significant correlation between radiographic results and parameter based on Pirani’s score.

Conclusion: Radiography is not an appropriate method to evaluate the effectiveness of the results of the Ponseti method in cases of unilateral idiopathic congenital clubfeet and may be indicated for after infancy or in treatments of neglected cases. There were no significant correlation between radiographic findings and clinical parameters used to assess correction.

Keywords: Clubfoot; Therapy; Clubfoot; Radiography; Foot Deformities; Congenital

References

  1. Ranade A., et al. “Ponseti Method for the treatment of idiopathic clubfoot". The Journal of Foot and Ankle Surgery (India)1 (2006).
  2. Dobbs MB. “Clubfoot: etiology and treatment: editorial comment”. Clinical Orthopaedics and Related Research5 (2009): 1119-1120.
  3. Siapkara A and Duncan R. “Congenital talipes equinovarus: a review of current management”. Journal of Bone and Joint Surgery. British Volume8 (2007): 995-1000.
  4. Dobbs MB and Gurnett CA. “Update on clubfoot: etiology and treatment”. Clinical Orthopaedics and Related Research5 (2009): 1146-1153.
  5. Dobbs MB., et al. “Treatment of idiopathic clubfoot: an historical review”. Iowa Orthopedic Journal 20 (2000): 59-64.
  6. Ponseti IV and Smoley EN. “Congenital clubfoot: the results of treatment”. Journal of Bone and Joint Surgery. American Volume2 (1963): 261-275.
  7. Ponseti IV. “Treatment of congenital club foot”. Journal of Bone and Joint Surgery. American Volume3 (1992): 448-454.
  8. Ponseti IV. “Common errors in the treatment of congenital clubfoot”. International Orthopaedics2 (1997): 137-141.
  9. Ippolito E and Ponseti IV. “Congenital club foot in the human fetus. A histological study”. Journal of Bone and Joint Surgery. American Volume1 (1980): 8-22.
  10. Colburn M and Williams M. “Evaluation of the treatment of idiopathic clubfoot by using the Ponseti method”. Journal of Foot and Ankle Surgery5 (2003): 259-267.
  11. vCooper DM and Dietz FR. “Treatment of idiopathic clubfoot. A thirty-year follow-up note”. Journal of Bone and Joint Surgery. American Volume10 (1995): 1477-1489.
  12. Ponseti IV., et al. “A radiographic study of skeletal deformities in treated clubfeet”. Clinical Orthopaedics and Related Research 160 (1981): 30-42.
  13. De Gheldere A and Docquier PL. “Analytical radiography of clubfoot after tenotomy”. Journal of Pediatric Orthopaedics6 (2008): 691-694.
  14. Ippolito E., et al. “A radiographic comparative study of two series of skeletally mature clubfeet treated by two different protocols”. Skeletal Radiology 8 (2003): 446-453.
  15. Radler C., et al. “Radiographic evaluation of idiopathic clubfeet undergoing Ponseti treatment”. Journal of Bone and Joint Surgery. American Volume6 (2007): 1177-1183.
  16. Lourenço AF and Morcuende JA. “Correction of neglected idiopathic club foot by the Ponseti method”. Journal of Bone and Joint Surgery. British volume 3 (2007): 378-381.
  17. Wang YZ., et al. “Application of Ponseti method in patients older than 6 months with congenital talipes equinovarus”. Beijing Da Xue Xue Bao4 (2009): 452-455.
  18. Nogueira MP., et al. “Ponseti Brasil: a national program to eradicate neglected clubfoot -preliminary results”. Iowa Orthopedic Journal 31 (2011): 43-48.
  19. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3215112/ Lehman WB., et al. “A method for the early evaluation of the Ponseti (Iowa) technique for the treatment of idiopathic clubfoot”. Journal of Pediatric Orthopaedics B2 (2003): 133-140.
  20. Dietz FR., et al. “Evaluation of a disease-specific instrument for idiopathic clubfoot outcome”. Clinical Orthopaedics and Related Research 5 (2009): 1256-1262.
  21. Perry J. “Anatomy and biomechanics of the hindfoot”. Clinical Orthopaedics and Related Research 177 (1983): 9-15.
  22. Prasad P., et al. “Clinico-radiological assessment and their correlation in clubfeet treated with postero-medial soft-tissue release”. International Orthopaedics1 (2009): 225-229.
  23. Metcalfe SA., et al. “The reliability of measurements taken from radiographs in the assessment of paediatric flat foot deformity”. Foot (Edinb)3 (2012): 156-162.
  24. Vanderwilde R., et al. “Measurements on radiographs of the foot in normal infants and children”. Journal of Bone and Joint Surgery. American volume 3 (1988): 407-415.
  25. Radler C., et al. “Interobserver reliability of radiographic measurements of contralateral feet of pediatric patients with unilateral clubfoot”. Journal of Bone and Joint Surgery. American Volume14 (2010): 2427-2435.
  26. Ponseti IV. “Congenital clubfoot - fundamentals of treatment”.
  27. Porecha MM., et al. “Mid-term results of Ponseti method for the treatment of congenital idiopathic clubfoot-- (a study of 67 clubfeet with meanfive year follow-up)”. Journal of Orthopaedic Surgery and Research 6 (2011): 3.
  28. Sætersdal C., et al. “Good results with the Ponseti method: a multicenter study of 162 clubfeet followed for 2-5 years”. Acta Orthopaedica3 (2012): 288-293.
  29. Ferreira LF., et al. “Comparison of hospital costs and duration of treatment with two different clubfoot protocols”. Iowa Orthopedic Journal 31 (2011): 49-51.
  30. Noh H and Park SS. “Predictive factors for residual equinovarus deformity following Ponseti treatment and percutaneous Achilles tenotomy for idiopathic clubfoot: a retrospective review of 50 cases followed for median 2 years”. Acta Orthopaedica2 (2013): 213-217.
  31. VHerbsthofer B., et al. “Significance of radiographic angle measurements in evaluation of congenital clubfoot”. Archives of Orthopaedic and Trauma Surgery 6-7 (1998): 324-329.
  32. Fridman MW and de Almeida Fialho HS. “The role of radiographic measurements in the evaluation of congenital clubfoot surgical results”. Skeletal Radiology2 (2007): 129-138.
  33. Bhargava SK., et al. “Radiography and sonography of clubfoot: A comparative study”. Indian Journal of Orthopaedics2 (2012): 229-235.
  34. Rakonjac Z., et al. “The effect of clinical, radiographic and functional scores on the total score in the evaluation of congenital clubfoot”. Medical Archives 4 (2014): 254-258.
  35. Agarwal A., et al. “Ultrasonographic evaluation of Achilles tendons in clubfeet before and after percutaneous tenotomy”. Journal of Orthopaedic surgery (Hong Kong)1 (2012): 71-74.
  36. Göksan SB. “Treatment of congenital clubfoot with the Ponseti method”. Acta Orthopaedica et Traumatologica Turcica4 (2002): 281-287.

Citation

Citation: Antonio Luiz Gonçalves Brandão., et al. “Radiographic Evaluation of Patients Undergoing Treatment of Idiopathic Clubfoot by the Ponseti Method”Acta Scientific Orthopaedics 6.3 (2023): 03-10.

Copyright

Copyright: © 2023 Antonio Luiz Gonçalves Brandão., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.




Metrics

Acceptance rate33%
Acceptance to publication20-30 days

Indexed In



News and Events


  • Certification for Review
    Acta Scientific certifies the Editors/reviewers for their review done towards the assigned articles of the respective journals.
  • Submission Timeline for Upcoming Issue
    The last date for submission of articles for regular Issues is June 25, 2024.
  • Publication Certificate
    Authors will be issued a "Publication Certificate" as a mark of appreciation for publishing their work.
  • Best Article of the Issue
    The Editors will elect one Best Article after each issue release. The authors of this article will be provided with a certificate of "Best Article of the Issue"
  • Welcoming Article Submission
    Acta Scientific delightfully welcomes active researchers for submission of articles towards the upcoming issue of respective journals.

Contact US