ABSTRACT
Objectif - La méthode de Ponseti est le traitement de choix du pied bot. Le but de cette étude prospective était d'évaluer les résultats du traitement avec le score de Pirani.Patients et méthodes - Deux cent quatre pieds bots idiopathiques (122 enfants) ont été traités par la méthode de Ponseti du 1er juin 2012 au 1er juin 2015. L'âge moyen des enfants à la première consultation était de 3 mois18 jours (2 jours - 1 an 11 mois). Le score de Pirani moyen était de 4,5/6. Le nombre moyen de plâtre était de 6,8. Une ténotomie a été faite pour 147 (72,1%) sous anesthésie locale à l'aide d'une aiguille. La dernière phase du traitement était le port de l'attelle d'abduction de Steenbeck.Résultats - Le score moyen de Pirani à la fin du traitement était de 0,3/6 ( 0 à 3/6). La correction était complète (n=173 ; 84,4%), modérée (n= 17 ; 8,3%), et incomplète (14 ;7,3%). Conclusion - Notre étude suggère que cette méthode lorsqu'elle est réalisée le plus tôtpar une équipe entrainée donne un excellent résultat morphologique et fonctionnel du pied permettant un chaussage normal
Subject(s)
Burundi , Drug Therapy , Foot Deformities , TalipesABSTRACT
Background: Congenital talipes equinovarus is the most common congenital anomaly of the foot and ankle. The prevalence of this condition in our environment is not known due to dearth of medical literature on the subject. The aim of this study was to determine the outcome of our operative management of resistant talipes equinovarus by elongation of tendo-Achilles and posteromedial soft tissue release. Methods: We present a retrospective review of congenital talipes equinovarus treated by Elongation of tendo Achilles (ETA) and Posterior Medial Release(PMR) at National Orthopaedic Hospital Enugu over a 6- year period (January1995- December 2000). Results: There were 63(68) males and 30(32) females with mean age of 2.06 years at presentation (range 1/12-18years). There was positive family history in 6(7) patients. More than half of the patients 63(68) came without any formal referral. The mode of delivery was spontaneous vaginal delivery in 81(87) and the first child appears to be more affected 22(24). The deformities on presentation varied from talipes equinovarus 50(54) to frank equinus in 3(3) and fifty-four (58) were bilateral. Sixty- three (68) had initial treatment ranging from serial casting in 46(50) to massage by traditional bonesetter in 2(2) and the average duration of this initial treatment was 20weeks (range 2-106weeks). The average age at surgery was 2.5years (range 3/12-24 years). All patients received postoperative cast for an average of 13 weeks. The commonest post- operative complication was medial wound breakdown. The average duration of follow-up was 30 weeks (range3weeks-3years). Some patients were lost to follow-up immediately the cast was removed. As at last visit 90were walking pain-free and do not require special shoe. The commonest residual deformity as at last visit was forefoot adduction in 17(18) patients. Conclusion: Elongation of tendo-Achilles and posteromedial soft tissue release are common operative procedures for CTEV. The short-term result of these procedures appears very good in our environment. However; the long-term result cannot be effectively analyzed due to high rate of loss to follow-up
Subject(s)
Achilles Tendon , Clubfoot , Foot Deformities , Surgical Procedures, OperativeABSTRACT
The purpose of this paper it to emphasise the importance of early detection and treatment of Congenital Talipes Equinovarus deformity (CTEVD). This deformity commonly known as Clubfoot often presents late for medical treatment in our sub-region. This is mainly due to socio-economic factors and probably cultural beliefs. The majority of patients operated on at the Department of Orthopaedics; at Mulago Hospital are normally the variety of neglected Clubfeet. Early detection and treatment of Clubfeet has better prognosis than delayed or neglected Clubfeet. The earlier correction is established; the lower the likelihood of relapses