Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “CLUBFOOT”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 235 records · Page 13Linked to original sources
PubMed1998

Scar quality from partial or complete wound closure using the Cincinnati incision for clubfoot surgery.

The method of skin closure in using the Cincinnati incision for clubfoot surgery may influence the quality of the scar obtained and the postoperative outcome. We retrospectively reviewed two groups of patients who underwent either primary skin closure (14 feet in 11 patients) or partial wound closure and healing by secondary intention (15 feet in 11 patients). The quality of the scars from both of these methods were equally acceptable cosmetically, and neither technique predisposed the patient to any long-term wound complications. In addition, we noted that closing the skin may act as a soft tissue tether, and that the initial position of the postoperative splinting of the foot may influence the surgical outcome. Both of these factors may contribute to the recurrence of equinovarus deformity.

Cicatrix↗
PubMed1999

Confirmation of arterial deficiencies in a limb with necrosis following clubfoot surgery.

This study describes postoperative necrosis of the hallux and first ray in a child with clubfoot. Arteriography performed on this child's lower limbs demonstrated, in the operated leg, hypoplasia of both the anterior and posterior tibial arteries and failure of the dorsalis pedis artery to traverse the tarsus and complete the deep plantar arch. Previously, congenital vascular deficiency was suggested to predispose such operated limbs to necrosis. These findings confirm the association between vascular deficiency and necrosis. In this present study, the metabolic demands of wound healing were sufficient in a limb with vascular deficiency to cause localized distal hypoperfusion leading to cyanosis and necrosis of the hallux and medial foot.

Abnormalities, Multiple↗
PubMed2000

Functional results of surgical treatment in congenital talipes equinovarus (clubfoot): a comparison of outcome measurements.

A total of 151 children with 234 grade 2 or grade 3 congenital talipes equinovarus were treated by lateral-posteromedial peritalar release utilizing the Cincinnati incision. The feet were reviewed independently after a mean follow-up period of 10 years (5-19 years), using a modified rating scale, and the results compared to the severity of the initial deformity. An excellent or good result was achieved in 196 feet (84%) and a modest correlation (r = 0.48) noted between the preoperative grading of the foot and the functional result at later review. Both gender and bilaterality were also influential since a boy with bilateral deformity has a 1 in 4 chance of only a fair result, compared to a girl with a unilateral clubfoot where the chance is 1 in 10. The total range of ankle movement and the talocalcaneal index correlated strongly with the eventual surgical outcome [r = 0.69 and 0.65 (P = 0.001 and 0.01) respectively].

Child, Preschool↗
PubMed2005

A comparison of resultant subtalar joint pathology with functional results in two groups of clubfoot patients treated with two different protocols.

Two series of patients with congenital clubfoot treated by different manipulation techniques and by different complementary soft tissue release operations were evaluated at the end of skeletal growth. The severity of the deformity was graded at diagnosis, and the functional results were graded at follow-up with a functional rating system. Computed tomography scans of the subtalar joint were also obtained at follow-up for each patient in order to evaluate the joint morphology. A linear regression model was constructed to study the statistical correlation between the rating score of the treated clubfeet and the shape of the subtalar joint. A statistically significant correlation was found between the clubfeet rating score and the subtalar joint morphology. However, the rating score values of the second series were consistently higher than those of the first series when compared with the same morphological category of the subtalar joint.

Adolescent↗
PubMed1983

New concept of and approach to clubfoot treatment: Section III--evaluation and results.

This final section on the new concept of and approach to treatment of clubfoot is the evaluation of 102 clubfeet treated over a 6-year period. Fifty-five unoperated feet received the surgical procedure described in Section II based on principles described in Section I. An attempt is made to evaluate the validity of correction of horizontal subtalar rotation, early ankle motion, recession of flexor tendon sheath on ankle motion and flexor hallucis longus function, early surgery, and release of the interosseous ligament. The results indicate that correction of horizontal subtalar rotation is beneficial and results in marked improvement in ankle motion by flexor tendon sheath recession and early motion. Longer follow-up is needed to determine the proper age for surgery. A rating system is developed and suggested for routine follow-up and comparison.

Age Factors↗
PubMedDate not supplied

Gait analysis in surgically treated clubfoot.

Clubfoot, a congenital foot abnormality, has been successfully managed with surgical treatment. To assess gait in individuals with surgically treated clubfeet, the patterns of electromyographic activity for the medical gastrocnemius and tibialis anterior muscles and the stride characteristics during gait were measured and compared with normal values. The duration of medial gastrocnemius activity was significantly greater than normal, whereas tibialis anterior activity, stride length, and single limb support times were not different. No correlation was found between the results of the gait analysis and the quality of the surgical result.

Child↗
PubMedDate not supplied

Conservative and surgical treatment of clubfoot.

One hundred twenty-four patients (174 feet) were treated for clubfoot deformity, with an average follow-up of 7 years. All patients were initially treated by manipulation and serial casting. Early soft tissue surgeries were performed for resistant cases (73 feet). In 33 feet with residual hindfoot deformity only, posterior release was performed with 85% good results. In the remainder, where there was forefoot as well as hindfoot deformity, full posteromedial release was necessary, giving good results in 90% of cases. All clubfeet should initially be treated conservatively. However, resistant cases should have early surgery, with the extent of surgery performed being determined by the type of residual deformity present.

Casts, Surgical↗
PubMedDate not supplied

Our experiences with the early operative treatment of congenital clubfoot.

In operative clubfoot therapy, early operation plays an important role. Between 1975 and 1982, we operated on 55 children with 72 clubfeet: 56 posteroplantar releases in patients with an average age of 5.8 months, and 16 posteromedial releases in patients with an average age of 8.1 months. The average follow-up was 3.5 years. The results, based on an investigation scheme according to Henkel, were good and very good in 94%. Operative treatment is indicated after 3 to 4 months of intensive plaster treatment if there has been no further correction.

Age Factors↗
PubMedDate not supplied

Comparative review of surgical treatment of the idiopathic clubfoot by three different procedures at Columbus Children's Hospital.

Ninety-nine feet in 54 children were both clinically and roentgenographically evaluated following one of three different procedures of soft tissue clubfoot release. A new rating system that weights dynamic functional results more heavily was used to compare results. Roentgenographic complications included both over- and undercorrection at the talonavicular articulation, avascular necrosis of the talus, navicular, and calcaneus, and talar dome flattening. Recommendations concerning technical aspects of operative approach to clubfeet include (a) more physiologic orientation of the bimalleolar axis, (b) anatomic alignment at the talonavicular joint, and (c) use of the hinged ankle cast brace to increase final ankle range of motion (ROM).

Braces↗
PubMedDate not supplied

A new orthosis for the management of clubfoot and other foot and leg deformities in infancy and early childhood.

A new orthosis designed to deal with unilateral or bilateral idiopathic clubfoot after successful conservative or surgical treatment was used to maintain the correction and to prevent recurrence. Once the neutral position of the heel was achieved, the orthosis was found to be very useful in improving the correction of the hind-foot and/or the forefoot. The first 50 patients treated with the orthosis showed a 92% compliance rate for an average period of 9-12 months.

Child, Preschool↗
PubMedDate not supplied

Conservative treatment of idiopathic clubfoot.

Operation in the early stage of clubfoot is still a controversial issue. Twenty-five patients treated conservatively were studied at the age of 4-16 years. In 95%, the outcome was either excellent or good according to Laaveg and Ponseti's rating system. Operation appears not to be indicated when the residual varus, adductus, or intoeing is passively correctable at least to the neutral position. Residual equinus without fixed varus was correctable by serial casting in childhood. Muscle imbalances, which make maintenance of the corrected position difficult in infancy, tend to improve with growth.

Biomechanical Phenomena↗
PubMedDate not supplied

Cause of toe-in gait after posteromedial release for congenital clubfoot.

Eighteen children with 24 congenital clubfeet were examined for their foot-progression angle and radiographic angles before and after Turco's posteromedial release. The foot-progression angle was -12.9 degrees before surgery and 1.6 degrees after surgery. The ratio of correction of the foot-progression angle was 58%. Using multiple regression analysis, this ratio was mostly related to the ratio of correction of the anteroposterior talo-first metatarsal and lateral talocalcaneal angles. These results suggest that it is important in correction of toe-in gait of congenital clubfoot to correct adduction deformity of the forefoot and equinus deformity of the hindfoot.

Child↗
PubMedDate not supplied

The use of caudal epidural anesthesia in clubfoot surgery.

We reviewed records of 31 children who had surgical release of 41 clubfeet under general anesthesia with supplemental caudal epidural anesthesia. Compared to an equivalent group of 27 children (39 feet), the caudal epidural group exhibited a statistically significant decrease in intraoperative narcotic requirement. One child had a bloody tap, and caudal epidural anesthesia was abandoned, but there were no other complications. Excellent postoperative pain relief persisted for > or = 8 h. Twenty-five of 31 caudal epidural patients were discharged safely on the same day as surgery without any surgical complications. Use of caudal epidural supplementation and outpatient surgery (where indicated) met with a high degree of parent satisfaction. Cost savings of outpatient clubfoot surgery, when compared to overnight stay, were disappointingly low.

Analgesics, Opioid↗
PubMed2002

Lumbar spinal stenosis causing congenital clubfoot.

Congenital lumbar spinal stenosis is believed to rarely cause neurologic symptoms during childhood. We present a 16-year-old boy with bilateral congenital clubfeet surgically corrected by tendo Achillis releases at 2 years of age who presented with progressive, bilateral footdrop. Magnetic resonance imaging of his lumbosacral spine showed severe spinal stenosis at the L3-5 vertebrae. Congenital lumbar spinal stenosis is probably an under-recognized cause of lower extremity neurologic abnormalities, including clubfoot deformity. Magnetic resonance imaging has made this eminently treatable disorder easier to recognize.

Adolescent↗
PubMedDate not supplied

Excision of the posterior tibial tendon during clubfoot release.

In 50 patients (72 clubfeet), the posterior tibial tendon was excised during complete soft tissue clubfoot release. The end results after an average of 3 years were graded as follows: 55.5% excellent, 29.3% good, 8.3% fair, and 6.9% poor. Heel varus and forefoot adduction were the main causes for recurrence. Heel valgus occurred in one foot. Excision of the posterior tibial tendon is safe, does not lead to overcorrection, and may prevent further scarring created when the tendon is lengthened.

Ankle Joint↗
PubMed1994

Gait analysis and dynamic foot pressure in the assessment of treated clubfoot.

Gait analysis and dynamic foot pressure were used in a follow-up study of 42 children with idiopathic clubfeet. Mean age at follow-up was 9 years (range 4-15 years). Twenty-four of the 62 clubfeet were treated conservatively and 38 had at least one operative intervention. Gait analysis showed that the vertical and posterior ground forces were significantly lower from the clubfoot compared with the normal foot. Dynamic foot pressure demonstrated a significant shift of the center of pressure to the lateral side in the affected compared with the normal side. In bilateral clubfeet, a relationship between center of pressure and subjective complaints was observed.

Acceleration↗
PubMed1987

The Ilizarov distractor for the correction of relapsed or neglected clubfoot.

The correction of a relapsed or neglected clubfoot by an external distractor is an alternative to a major operation which may involve triple arthrodesis and is often associated with skin problems. We report the use of the Ilizarov method to treat nine severely deformed feet, with satisfactory results in terms of function and appearance. The distractor enables treatment to be applied before maturity and avoids the shortening of the foot that results from wedge osteotomies. We discuss the indications, technique, complications and results of the method.

Adolescent↗