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Is it Possible to Treat Recurrent Clubfoot with the Ponseti Technique After Posteromedial Release?: A Preliminary Study

  • Symposium: Clubfoot: Etiology and Treatment
  • Published:
Clinical Orthopaedics and Related Research

Abstract

The Ponseti technique for treating clubfoot has been popularized for idiopathic clubfoot and more recently several syndromic causes of clubfoot. We asked whether it could be used to treat recurrent clubfoot following failed posteromedial release. We retrospectively reviewed 58 children (83 clubfeet) treated by the Ponseti technique for recurrent deformity after posteromedial release in three centers. The minimum followup was 24 months (average, 45 months; range, 24–80 months). We determined initial and final Pirani scores and range of motion of the ankle and subtalar joint. Plantigrade and fully corrected feet were obtained in 71 feet (86%); 11 feet obtained partial correction; one patient failed treatment and underwent another posteromedial release. Recurrences occurred in nine patients (12 feet or 14%). Initial Pirani scores improved in all but one patient; severity of deformity was also inferred by number of casts used for treatment. The age at treatment and numbers of casts did not influence the scores of Pirani et al. The scores were similar among the three orthopaedic surgeons.

Level of Evidence: Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

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Acknowledgments

We thank Luis Felipe C. Neves, MD, Waldir Wilson Vilela Cipola, MD, Paulo Oliveira Machado, MD, José I. Yebra, MD, Laia S. Cequier, MD, and Marta V. Pujol, MD, for the institutional support in developing this manuscript. We also thank Harold van Bose for the English editing and reviewing the first version of this manuscript, and Valeria Baltar for the repeated statistical analysis of this study.

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Authors and Affiliations

  1. Pediatric Orthopaedic Group, Orthopaedics Department, Hospital do Servidor Público Estadual, São Paulo, Brazil

    Monica Paschoal Nogueira MD

  2. Juriti Avenue, 541, apt 42, 04520 001, São Paulo, SP, Brazil

    Monica Paschoal Nogueira MD

  3. Orthopaedics Department, Hospital Sant Joan de Deu, Barcelona, Spain

    Anna Maria Ey Batlle MD

  4. Orthopaedics Department, Hospital Central do Funchal, Funchal, Madeira, Portugal

    Cristina Gomes Alves MD

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  1. Monica Paschoal Nogueira MD
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  2. Anna Maria Ey Batlle MD
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  3. Cristina Gomes Alves MD
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Correspondence to Monica Paschoal Nogueira MD.

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Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.

Each author certifies that his or her institution either has waived or does not require approval for the human protocol for this investigation and that all investigations were conducted in conformity with ethical principles of research.

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Nogueira, M.P., Ey Batlle, A.M. & Alves, C.G. Is it Possible to Treat Recurrent Clubfoot with the Ponseti Technique After Posteromedial Release?: A Preliminary Study. Clin Orthop Relat Res 467, 1298–1305 (2009). https://doi.org/10.1007/s11999-009-0718-9

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  • DOI: https://doi.org/10.1007/s11999-009-0718-9

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