Talipes Equinovarus Treatment in Infants Treated by the Ponseti Method Compared With Posterior-Only Release: A Mid-Childhood Comparison of Results.

The aim of this study is to evaluate children in middle childhood with clubfoot treated with Ponseti method vs posterior-only release and to compare their results to a control group with 4 modules (physical examination, gait study, radiographic measurements, and questionnaires). From 01/01/2004 until 01/01/2009, 31 children (45 feet) were treated with the posterior-only release protocol and 22 patients (34 feet) were treated with the Ponseti method. In 2016, patients were evaluated and compared with 25 children without neuromuscular disorders. Parents completed 3 outcome questionnaires. Radiographs evaluated residual deformity and osteoarthritis. A physical examination and a 3-dimensional gait analysis were performed to evaluate range of motion, kinematic, and kinetic data. Recurrence rate was similar between treatment groups; however, type of surgery to treat residual deformity was more aggressive in the posterior-only release (91% required major surgery), p = .024. Radiographic examination showed similar residual deformity with greater hindfoot varus in posterior-only release (68%), p = .02. Reduced cadence, increased stance dorsiflexion, calcaneus gait and forced eversion prior to swing were the main characteristics of gait in posterior-only release. Four (11%) feet treated with posterior-only release vs 11 (33%) feet treated with Ponseti method had a normal gait, p = .016. Our study showed that biomechanical function and long-term outcomes of children in middle childhood treated with the Ponseti method more closely compare with healthy individuals than those treated using posterior-only surgical technique.

Estudio mediante una técnica no lesiva, basada en la luz estructurada, de la topografia de la espalda de futbolistas / Study of back topography of football players by a nonlesive method based on structured light

Se presenta un método no lesivo basado en la proyección de luz estructurada con código de color para la obtención de la topografía de la superficie de la espalda en deportistas. El método permite la visualización de las asimetrías existentes en las distintas zonas de la espalda, cervical, dorsal y lumbar, tomando como referencia la posición de las cervicales y de los glúteos. La determinación en estas topografías de variables cuantificadoras para caracterizar la deformidad, tanto en el plano frontal como transversal, permite realizar un diagnóstico precoz de la existencia de patologías asociadas con desviación de la columna en los deportistas integrantes de los clubs deportivos, sobre todo en las edades infantiles y juveniles, donde la prevalencia de la escoliosis es mayor. En este trabajo se ha introducido una nueva variable, el gradiente lumbar, que permite identificar la elevación de los glúteos respecto de la cintura, para cuantificar el desarrollo de los glúteos asociado a la práctica deportiva, así como la asimetría de la zona lumbar. Estas variables topográficas han resultado independientes de la altura y edad de los sujetos del estudio y, por tanto, pueden resultar de interés para valorar el efecto del entrenamiento deportivo en la musculatura, tanto a nivel dorsal como lumbar, a lo largo de la evolución del deportista en estudios longitudinales, así como para realizar las oportunas comparaciones entre las distintas actividades deportivas. En nuestro estudio, aplicado aun equipo de fútbol, se ha podido comprobar el mayor número de valores elevados de la variable que mide la deformidad en el plano horizontal en el grupo de edad de los 14 a los 15 años y una ligera variación en función de la posición que ocupan en el campo (AU)

We present a noninvasive method based on structured light projection with color code to obtain the topography of the back surface in athletes. The method allows the display of the asymmetries in the areas of the back, cervical, dorsal and lumbar, with reference to the position of the neck and buttocks. The determination of quantifier variables in these topographies to characterize the deformity in both the frontal and transverse plane allows an early diagnosis of the existence of pathologies associated with curvature of the spine in athletes members of sports clubs, especially in children and youth ages where the prevalence of scoliosis is greater. In this paper we have introduced a new variable, the lumbar gradient, which identifies the elevation of the buttocks on the waist, to quantify the development of the buttocks associated with the sport, and the asymmetry of the lumbar area. These topographic variables were independent of height and age of athletes and therefore may be of interest to assess the effect of sport training in the musculature, both dorsal and lumbar, along of the evolution the athlete and to make appropriate comparisons between different sport activities. In our study, applied to a football team, it has been found the most elevated values of the variable that measures the deformity in the horizontal plane in the age group of 14 to 15 years and a slight variation depending on the playing position (AU)