PONSETI METHOD AS A TREATMENT OPTION FOR NEGLECTED CLUBFOOT. CASE REPORT AND LITERATURE REVIEW

https://www.doi.org/10.22551/MSJ.2021.01.15

  • CORBU A. “Carol Davila” University of Medicine and Pharmacy Bucharest, Romania
  • VASILESCU Dana Elena “Iuliu Hațieganu” University of Medicine and Pharmacy Cluj-Napoca
  • MAXIM A. “Iuliu Hațieganu” University of Medicine and Pharmacy Cluj-Napoca
  • CRISTEA S. Carol Davila” University of Medicine and Pharmacy Bucharest, Romania
  • COSMA D. I. “Iuliu Hațieganu” University of Medicine and Pharmacy Cluj-Napoca

Abstract

Congenital clubfoot is a common congenital malformation, whose conservative treatment using the Ponseti method achieves excellent initial correction rates and good long-term results. On the other hand, neglected clubfeet, which are typically more frequent in underdeveloped and developing countries, pose treatment difficulties and render corrective surgery necessary. The main problems with correction are raised by the increasing stiffness present in the soft tissues and the dysplastic development of bones. Furthermore, the hyperlaxity of young children decreases with growth, contributing to the reduced overall elasticity of the affected soft tissues and clubfeet. Deciding upon which type of treatment would be appropriate is not always facile. In our clinic, we tend to start the treatment of neglected clubfeet with the modified Ponseti method, which can achieve partial correction or full correction in most cases, diminishing the need for extensive surgical procedures. The case report of a long time neglected bilateral clubfoot successfully corrected using the modified Ponseti method is presented below, followed by a relevant review of the literature.

Author Biographies

CORBU A., “Carol Davila” University of Medicine and Pharmacy Bucharest, Romania

Department of Orthopedics and Traumatology
Clinical Rehabilitation Hospital Cluj-Napoca,
Department of Orthopedics and Traumatology

VASILESCU Dana Elena, “Iuliu Hațieganu” University of Medicine and Pharmacy Cluj-Napoca

Department of Orthopedics-Traumatology and Pediatric Orthopedics

MAXIM A., “Iuliu Hațieganu” University of Medicine and Pharmacy Cluj-Napoca

Department of Orthopedics-Traumatology and Pediatric Orthopedics

CRISTEA S., Carol Davila” University of Medicine and Pharmacy Bucharest, Romania

Department of Orthopedics and Traumatology

COSMA D. I., “Iuliu Hațieganu” University of Medicine and Pharmacy Cluj-Napoca

Department of Orthopedics-Traumatology and Pediatric Orthopedics
Clinical Rehabilitation Hospital Cluj-Napoca,
Department of Orthopedics and Traumatology

References

1. McConnell L, Cosma D, Vasilescu D, Morcuende J. Descriptive epidemiology of clubfoot in Romania: a clinic-based study. Eur Rev Med Pharmacol Sci 2016; 20(2): 220-224.
2. Corbu A, Cosma D, Vasilescu DE, Cristea S. Congenital Talipes equinovarus: current concepts and treatment. Rev Med Chir Soc Med Nat Iasi 2017; 121(4): 745-751.
3. Wang H, Barisic I, Loane M, et al. Congenital clubfoot in Europe: A population-based study. Am J Med Genet A. 2019;179(4): 595-601 / doi: 10.1002/ajmg.a.61067.
4. Ponseti IV, Campos J. The classic: observations on pathogenesis and treatment of congenital clubfoot. Clin Orthop Relat Res 2009; 467(5): 1124‐1132 / doi:10.1007/s11999-009-0721-1.
5. Corbu A, Cosma DI, Vasilescu DE, Cristea S. Posteromedial Release versus Ponseti Treatment of Congenital Idiopathic Clubfoot: A Long-Term Retrospective Follow-Up Study into Adolescence. Ther Clin Risk Manag 2020; 16: 813-819 / doi: 10.2147/TCRM.S262199.
6. Zhao D, Li H, Zhao L, Liu J, Wu Z, Jin F. Results of clubfoot management using the Ponseti method: do the details matter? A systematic review. Clin Orthop Relat Res 2014; 472(4): 1329‐1336 / doi:10.1007/s11999-014-3463-7
7. Lourenço AF, Morcuende JA. Correction of neglected idiopathic club foot by the Ponseti method. J Bone Joint Surg Br 2007; 89: 378-381.
8. Penny JN. The neglected clubfoot. Techn Orthop 2005; 20(2): 153-166.
9. Cosma DI, Vasilescu DE. Ponseti treatment for clubfoot in Romania: a 9-year single-centre experience. Journal of Pediatric Orthopaedics B 2014; 23(6): 512-6 /doi: 10.1097/BPB.0000000000000081
10. Corbu A, Vasilescu DE, Andrei M, Cristea S. Radiological assessment of residual deformities of surgically treated idiopathic congenital clubfeet during early infancy. HVM Bioflux 2019; 11(3): 95-99.
11. Adegbehingbe OO, Adetiloye AJ, Adewole L, et al. Ponseti method treatment of neglected idiopathic clubfoot: Preliminary results of a multi-center study in Nigeria. World J Orthop 2017; 8(8): 624-630 / doi: 10.5312/wjo.v8.i8.624.
12. de Podestá Haje D. Neglected Idiopathic Bilateral Clubfoot Successfully Treated with the Ponseti Method: A Case Report. JBJS Case Connect 2013; 3(1): e9 / doi:10.2106/JBJS.CC.L.00144.
13. Sinha A, Mehtani A, Sud A, Vijay V, Kumar N, Prakash J. Evaluation of Ponseti method in neglected clubfoot. Indian J Orthop 2016; 50(5): 529‐535 / doi:10.4103/0019-5413.189597.
14. Spiegel DA, Shrestha OP, Sitoula P, et al. Ponseti method for untreated idiopathic clubfeet in Nepalese patients from 1 to 6 years of age. Clin Orthop Relat Res 2009; 467: 1164-1170 / doi:10.1007/ s11999-008-0600-1
15. Ayana B, Klungsøyr PJ. Good results after Ponseti treatment for neglected congenital clubfoot in Ethiopia. A prospective study of 22 children (32 feet) from 2 to 10 years of age. Acta Orthop 2014; 85(6): 641‐645 / doi:10.3109/17453674.2014.957085.
16. Ranjan R, Sud A, Adhikary D, Sinha A, Chand S. Incidence and risk factors for iatrogenic distal tibia/fibula fracture during Ponseti technique of clubfoot treatment. J Pediatr Orthop B 2019; 28(6): 572-578 / doi:10.1097/BPB.0000000000000595.
Published
2021-03-30