RESUMEN
Background: Clubfoot is a congenital deformity that can affect one or both of a newborn's lower extremities. The main objective of the study is to evaluate and compare the outcomes of the Ponseti method for the management of different types of clubfoot. Methods: A retrospective analysis of 151 children with 253 clubfeet (idiopathic untreated, idiopathic recurrent, and syndromic) with at least one year of follow-up was conducted in four months after ethical approval. Data were collected with a structured proforma after the consent of the parents. An independent sample t-test was applied to show the comparison between the groups, and a p-value of 0.05 was considered significant. Results: Out of 151 patients, 76% were male and 24% were female. Out of a total of 235 feet, 96 (63%) were idiopathic untreated, 40 (26.5%) were idiopathic recurrent, and 15 (9.5%) were syndromic clubfoot. The average number of casts was higher in syndromic clubfoot (9 casts per foot). There was no significant difference in the baseline Pirani score of the three groups (p-value > 0.05); but after one year of follow-up, there was a significant difference in the Pirani score of idiopathic and syndromic clubfoot (p-value ≤ 0.05) and between recurrent clubfoot and syndromic clubfoot (p-value = 0.01). Conclusions: The aetiology of syndromic clubfoot affects the outcomes of the Ponseti method and leads to relapse. In idiopathic (untreated and recurrent) clubfoot, the Ponseti method does not produce a significant difference in outcome. Poor brace compliance and a lack of tenotomy lead to orthotic (ankle foot orthosis AFO and foot orthosis FO) use in the day time and the recurrence of clubfoot deformity in these three types of clubfoot.
RESUMEN
OBJECTIVE: To assess the frequency of mirror movements in spastic cerebral palsy children and to compare hand function and functional independence of such children with and without mirror movements. . METHODS: The comparative cross-sectional study was conducted in special education schools of Lahore and Islamabad from August 2017 to January 2018, and comprised children of either gender aged 5-18 years diagnosed with spastic cerebral palsy who were able to make a gross grip. Wood and Teuber criteria for the assessment of mirror movements and Jebsen-Taylor hand function test for hand function assessment were used, while manual ability classification system was used for the assessment of functional independence. Data was analysed using SPSS 21. RESULTS: Of the140 subjects, 113(80.7%) were boys and 27(19.3%) were girls. The overall mean age was 11.17}3.69 years. Of the total, 51(36.4%) subjects had diplegic cerebral palsy, while 50(35.7%) were suffering from mirror movements. There was no difference in the unimanual hand function of children with and without mirror movements (p>0.05). However, children without mirror movements had more functional independence (p<0.001). CONCLUSIONS: Mirror movement was found in one third of the sample, and there was no difference in hand function in children with and without mirror movements.