|
The Journal of Bone and Joint Surgery, Vol 77, Issue 10 1477-1489, Copyright © 1995 by Journal of Bone and Joint Surgery, Inc
Treatment of idiopathic clubfoot. A thirty-year follow-up note
DM Cooper and FR Dietz
Department of Orthopaedic Surgery, University of Iowa Hospitals and Clinics, Iowa City 52242, USA.
We evaluated forty-five patients who had seventy-one congenital clubfeet.
The average age was thirty-four years (range, twenty-five to forty-two
years). Twenty-nine of these patients had been evaluated and reported on in
1980. We performed pedobarographic and electrogoniometric analyses in
addition to the clinical and radiographic studies performed previously.
With the use of pain and functional limitation as the outcome criteria,
thirty-five (78 per cent) of the forty-five patients had an excellent or
good outcome compared with eighty-two (85 per cent) of ninety-seven
individuals who did not have congenital deformity of the foot. The
patient's occupation, passive dorsiflexion as measured with a hand-held
goniometer, the antero-posterior calcaneus-fifth metatarsal angle, the
total foot pressure time integral, and the number of rapid single-limb
toe-ups that could be performed were the only variables that differed
significantly between the feet that had an excellent or good result and
those that had a poor result (p < 0.05). A comparison of the feet that
had an excellent or good outcome with those that had a poor outcome with
regard to body-mass index, peak pressure under the heel, and force time
integral under the metatarsal heads revealed a p value that was between
0.05 and 0.08 for each variable. The technique of treatment led to good
long-term results in our patients who had clubfoot. The data suggest that a
sedentary occupation and avoidance of excessive weight gain may improve the
over-all long-term result. Excessive weakening of the triceps surae may
predispose patients to a poor result; therefore, it is prudent to avoid
overlengthening of this muscle. The outcome could not be predicted from the
radiographic result.
 CiteULike  Connotea  Del.icio.us  Technorati What's this?
This article has been cited by other articles:
|
|
|
|
 
S. Boehm, N. Limpaphayom, F. Alaee, M. F. Sinclair, and M. B. Dobbs
Early Results of the Ponseti Method for the Treatment of Clubfoot in Distal Arthrogryposis
J. Bone Joint Surg. Am.,
July 1, 2008;
90(7):
1501 - 1507.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. El-Hawary, L. A. Karol, K. A. Jeans, and B. S. Richards
Gait Analysis of Children Treated for Clubfoot with Physical Therapy or the Ponseti Cast Technique
J. Bone Joint Surg. Am.,
July 1, 2008;
90(7):
1508 - 1516.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
G. F. Haft, C. G. Walker, and H. A. Crawford
Early Clubfoot Recurrence After Use of the Ponseti Method in a New Zealand Population
J. Bone Joint Surg. Am.,
March 1, 2007;
89(3):
487 - 493.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. M. Schwend
Idiopathic Clubfoot Deformity in Infants Is Best Treated with Conservative Techniques
AAP Grand Rounds,
May 1, 2006;
15(5):
59 - 60.
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. B. Dobbs, R. Nunley, and P. L. Schoenecker
Long-Term Follow-up of Patients with Clubfeet Treated with Extensive Soft-Tissue Release
J. Bone Joint Surg. Am.,
May 1, 2006;
88(5):
986 - 996.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
F. Zeifang, C. Carstens, S. Schneider, and M. Thomsen
Continuous passive motion versus immobilisation in a cast after surgical treatment of idiopathic club foot in infants: A PROSPECTIVE, BLINDED, RANDOMISED, CLINICAL STUDY
J Bone Joint Surg Br,
December 1, 2005;
87-B(12):
1663 - 1665.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
H. Huber and M. Dutoit
Dynamic Foot-Pressure Measurement in the Assessment of Operatively Treated Clubfeet
J. Bone Joint Surg. Am.,
June 1, 2004;
86(6):
1203 - 1210.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. A. Morcuende, L. A. Dolan, F. R. Dietz, and I. V. Ponseti
Radical Reduction in the Rate of Extensive Corrective Surgery for Clubfoot Using the Ponseti Method
Pediatrics,
February 1, 2004;
113(2):
376 - 380.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. B. Dobbs, J.R. Rudzki, D. B. Purcell, T. Walton, K. R. Porter, and C. A. Gurnett
Factors Predictive of Outcome After Use of the Ponseti Method for the Treatment of Idiopathic Clubfeet
J. Bone Joint Surg. Am.,
January 1, 2004;
86(1):
22 - 27.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
K. J. Noonan and B. S. Richards
Nonsurgical Management of Idiopathic Clubfoot
J. Am. Acad. Ortho. Surg.,
November 1, 2003;
11(6):
392 - 402.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
E. Ippolito, P. Farsetti, R. Caterini, and C. Tudisco
Long-Term Comparative Results in Patients with Congenital Clubfoot Treated with Two Different Protocols
J. Bone Joint Surg. Am.,
July 3, 2003;
85(7):
1286 - 1294.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. A. Buckwalter
Advancing the Science and Art of Orthopaedics : Lessons from History
J. Bone Joint Surg. Am.,
December 1, 2000;
82(12):
1782 - 1782.
[Full Text]
|
|
|
|
