Clinical outcomes of iatrogenic complex clubfoot treated with modified Ponseti method
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ORIGINAL PAPER
Clinical outcomes of iatrogenic complex clubfoot treated with modified Ponseti method Serda Duman 1 & Yalkin Camurcu 2 & Adem Cobden 3 & Hanifi Ucpunar 2 & Nazim Karahan 1 & Aysegul Bursali 4 Received: 3 December 2019 / Accepted: 4 March 2020 # SICOT aisbl 2020
Abstract Introduction There are not enough studies demonstrating the results of the modified Ponseti method on iatrogenic complex clubfoot that occurs due to errors during the application of the method for treating idiopathic clubfoot. The present study aimed to present the treatment results of the modified method reported by Ponseti for treating feet that became complex solely due to errors during casting. Methods Patients with the confirmed diagnosis of iatrogenic complex clubfoot were according to initial physicians’ report and photographs were included in this retrospective case series study. Patients with congenital atypical feet, incomplete medical records, and accompanying pathologies were excluded from the study. Patients’ clinical data and clinical scores were recorded at the initial visit and at the latest follow-up. Results There were 21 children (15 boys and 8 girls) with 32 complex clubfeet. Initial correction was achieved in all children, with an average of five serial casts (range 3 to 6 casts). At the last follow-up, ISGCF score of 25 feet (78.1%) was excellent and seven feet (21.9) was good. Conclusion According to the results acquired from this study, an iatrogenic complex clubfoot can be successfully treated using the modified Ponseti method. Keywords Complex clubfoot . Talipes equinovarus . Ponseti . ISGCSF
Introduction Idiopathic congenital clubfoot is one of the most commonly observed paediatric congenital pathologies with an occurrence rate of 0.5–2 in per 1000 live births [1]. Reportedly, 150,000– 200,000 new cases are diagnosed each year worldwide, of which 80% occur in developing countries [2]. Clubfoot comprises a combination of cavus, equinus, hindfoot varus, and metatarsus adductus deformities of the foot. The treatment method introduced by Ignacio Ponseti that involves a series
of manipulations and serial casts has been globally accepted as the gold standard treatment and has been successfully performed for years [2–4]. Satisfactory clinical outcomes have been reported in approximately 90% of cases worldwide [5–7]. The reasons for failure during treatment are due to a lack of experience in the application of the method and lack of knowledge regarding the kinematics and pathoanatomy of the deformity. The most common mistakes regarding the method have been reported in detail by Ponseti [8]. The foot condition
* Serda Duman [email protected]
Aysegul Bursali [email protected]
Yalkin Camurcu [email protected]
1
Department of Orthopaedics and Traumatology, Selahaddin Eyyubi State Hospital, Yenisehir Mahallesi, 21100 Diyarbakir, Turkey
Adem Cobden [email protected]
2
Department of Orthopaedics and Traumatology, Erzincan University Faculty of Medicine, Basbaglar Mahallesi, 24030 Erzincan, Tu
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