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Ultrasound assessment of early clubfoot treatment : a comparison of the Ponseti method and a modified Copenhagen method
AURELL Y; ANDRIESSE H; JOHANSSON A; JONSSON K
J PEDIATR ORTHOP B , 2005, vol. 14, n° 5, p. 347-357 Doc n°: 122514 Localisation : Documentation IRR Descripteurs : DE831 - PIED BOT VARUS EQUIN The purpose of this study was to sonographically compare the early anatomical outcome of a group of clubfeet treated with the Ponseti method (group A, nine clubfeet) with a group treated with an adjustable plexidur splint, the Copenhagen method (group 13, 19 feet). The clinical severity was assessed using the Dimeglio-Bensahel classification. The need for complementary surgery was clinically assessed at the age of about 2 months. Ultrasound investigation was made in the neonatal period, after 2-3 months of non-surgical treatment and 1-2 months post-surgically. After 2 months of non-surgical treatment the correction obtained at the talo-navicular joint, expressed as the distance between the medial malleolus and the navicular (MM-N distance), was significantly greater in group A. After surgery, tenotomy of the Achilles tendon for all group A feet, and posterior or posteriomedial release for 13 feet in group B, the correction at the talonavicular and calcaneo-cuboid joints was similar for the two groups. Anatomical correction of the displacement in these joints can be achieved without extensive interventional procedures. Ultrasound may be a valuable tool to assess the effects of different treatment protocols quantitatively. Langue : ANGLAIS Tiré à part : OUI |
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