Results of ala carte Posteromedial Soft Tissue Release in Idiopathic Clubfoot
https://doi.org/10.5704/MOJ.2107.013
- Author:
Barik S
1
;
Das L
1
;
Yadav AK
1
;
Arora SS
1
;
Singh V
1
Author Information
1. Department of Orthopaedics, All India Institute of Medical Sciences Rishikesh, Rishikesh, India
- Publication Type:Journal Article
- Keywords:
clubfoot, posteromedial release, scar, Ponseti casting
- From:Malaysian Orthopaedic Journal
2021;15(No.2):89-95
- CountryMalaysia
- Language:English
-
Abstract:
Introduction: The aim of this study is to assess the
outcomes of ala carte posteromedial release in children over
two years of age who were not responding to the Ponseti
method of treatment of idiopathic clubfoot.
Materials and Methods: A retrospective observational
study from September 2013 to August 2015 was conducted
at a tertiary level medical teaching institution. The clubfeet
were classified according to the Harold and Walker
classification. Radiographic parameters assessed were the
talocalcaneal angle (AP, lateral), talus-first metatarsal angle
(AP, lateral) and calcaneal-fifth metatarsal angle. The scar
and the functional score, according to Laaveg and Ponseti,
were evaluated as outcome measures at the final follow-up.
Results: Twenty-four children with a mean age of 43.7 ±
24.7 months were enrolled in the study. There was a total of
36 clubfeet: 21 (65.6%) with a poor functional outcome; 12
(37.4%) with excellent to good scar in both horizontal and
vertical components. There was a statistical significance
between the pre-operative and post-operative radiological
parameters (p<0.05). None of the patients presented with any
limitation of activities of daily living despite the poor
functional outcome in many of the children. There was no
significant association between the qualities of scar
(horizontal, vertical) and the functional outcome with age at
presentation, pre-operative Harold and Walker classification
and pre-operative radiographic angles.
Conclusion: Surgical intervention in terms of ala carte
posteromedial soft tissue release could not produce a good
outcome over four years in CTEV. The threshold for surgery
in CTEV should be high, given the poor results.
- Full text:16.2021my1179.pdf
