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A Single-Center Evaluation of Mid-Term Results of Ponseti Management for Nonidiopathic Congenital Clubfeet in Vietnam

Year: 2020
Type: article
Abstract: By comparing initial correction, early relapses, latest follow-up mid-term results between idiopathic and nonidiopathic congenital clubfeet, this study is to define the efficacy of the Ponseti method for the nonidiopathic clubfeet. 32 nonidiopathic congenital clubfeet (group 1) in 21 children and 118 idiopathic congenital clubfeet (group 2) in 82 children (newborn to 12 months) are recruited for this study, following treatment with the Ponseti method with a follow-up period of a minimum of two years. The clubfeet are classified and evaluated during casting, of initial correction, and for early relapse according to Diméglio’s score. The latest follow-up results are evaluated according to Richards’ classification. The initial correction is successfully 81.3% in group 1, and 96.6% in group 2 (p=0.019). The early relapses are 26.9% in group 1, and 7.0% in group 2 (p=0.003); for group 1, 57.1% of early relapses were subjected to medial posterior release and for group 2, all of early relapses were successfully managed by casting (p < 0.001). The latest follow-up results are good 21.9%, fair 46.8%, poor 31.3% in group 1, and good 76.3%, fair 22.0%, poor 1.7% in group 2 (p < 0.001). This study indicates that the Ponseti method is successfully applied to nonidiopathic clubfeet. However, the early relapse rate of nonidiopathic clubfeet is high and most of these relapsing clubfeet need to be managed by posteromedial release. In addition, posteromedial release should be indicated as the initially definite management for very severe clubfeet of arthrogryposis.
DOI: 10.11648/j.ajp.20200603.17
Language: English
Field: Medicine
Open Access status: diamond
OpenAlex ID: W3028702017
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Cites: 18
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Related to: 10