科研之友
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摘要
Aim: The Ponseti method is accepted worldwide for the treatment of congenital clubfoot. We report about our experience in a 7-year period. The purpose of the study was to evaluate the history of well treated feet between primary correction and the age of 5-6 years with relapse rate and functional results.
Material and Method: Between 1.1.2004 and 31.12.2005 we treated 71 patients with 102 idiopathic clubfeet with the Ponseti method. All patients were prospectively evaluated. We used the Pirani score. The patients' results were documented when the children started to walk and before primary school. The results were compared and statistically evaluated. We used the McKay score and measured the talocalcaneal angle on lateral and a. p. radiographs.
Results: 89% clubfeet were successful treated with the Ponseti method. At walking age plantar flexion was between 30 degrees und 50 degrees (empty set 42 degrees) and dorsiflexion between 5 degrees and 30 degrees (empty set 25 degrees). Before primary school plantar flexion was between 30 and 50 degrees (empty set 37,8 degrees) and dorsiflexion between 0 degrees and 25 degrees (empty set 13,9 degrees). Using the McKay score we had 91% excellent or good results. 31% cases had surgical treatment of a relapse. In the relapse group 82% had an excellent or good result according to the McKay score.
Conclusion: The Ponseti method is a very effective technique to treat idiopathic clubfeet. In the first 5 to 6 years of age there is a significant loss of range of motion. The relapse rate is comparable to those of other clubfoot treatment concepts. The relapse treatment of the Ponseti technique, with recasting, tibialis anterior tendon transfer and Achilles tendon lengthening leads to good functional results.
- 出版日期2012-4
