RESUMEN
BACKGROUND: The Ponseti method has been shown to be the most effective treatment for congenital clubfoot. The current challenge is to establish sustainable national clubfoot treatment programs that utilize the Ponseti method and integrate it within a nation's governmental health system. The Brazilian Ponseti Program (Programa Ponseti Brasil) has increased awareness of the utility of the Ponseti method and has trained >500 Brazilian orthopaedic surgeons in it. METHODS: A group of 18 of those surgeons had been able to reproduce the Ponseti clubfoot treatment, and compiled their initial results through structured spreadsheet. RESULTS: The study compiled 1040 patients for a total of 1621 feet. The average follow-up time was 2.3 years with an average correction time of approximately 3 months. Patients required an average of 6.40 casts to achieve correction. CONCLUSIONS: This study demonstrates that good initial correction rates are reproducible after training; from 1040 patients only 1.4% required a posteromedial release. LEVEL OF EVIDENCE: Level IV.
Asunto(s)
Moldes Quirúrgicos , Pie Equinovaro/terapia , Manipulación Ortopédica/métodos , Tenotomía , Tendón Calcáneo/cirugía , Preescolar , Países en Desarrollo , Femenino , Accesibilidad a los Servicios de Salud/normas , Humanos , Lactante , Masculino , Evaluación de Programas y Proyectos de Salud , Tenotomía/métodos , Resultado del TratamientoRESUMEN
This study aimed to analyze the perceptions of parents of children with clubfoot regarding the Ponseti method of treatment, and identify aspects of treatment that families found most difficult. Thirty families of children with clubfoot were treated with the Ponseti method over a 4-year period, and questionnaires were distributed at the conclusion of treatment. The most difficult components of treatment were identified. However, these challenges did not impact treatment outcome negatively. We hypothesize that a strong physician-patient relationship and high levels of parental education may decrease perceived difficulties of treatment with the Ponseti method.
Asunto(s)
Tendón Calcáneo/cirugía , Pie Equinovaro/terapia , Manipulación Ortopédica/métodos , Tenotomía/métodos , Adolescente , Niño , Preescolar , Femenino , Estudios de Seguimiento , Humanos , Masculino , Equipo Ortopédico , Resultado del TratamientoRESUMEN
A ossificação do ligamento longitudinal posterior da coluna cervical com mielopatia compressiva é patologia frequente na população japonesa, sendo muito rara na população brasileira. Os autores relatam o caso de uma paciente de cor negra, portadora de ossificaçã do ligamento longitudinal posterior com mielopatia cervical e discutem os aspectos clínicos e terapêuticos.