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R B Giesberts, M C van der Steen, P G M Maathuis, A T Besselaar, E E G Hekman, G J Verkerke
BACKGROUND: Clubfeet are commonly treated using the Ponseti method. This method involves weekly manipulation and casting which gradually corrects the position of the foot. However, the reasons for following a weekly interval are not clear. QUESTION / PURPOSE: The aim is to investigate the influence of the cast change interval on treatment outcomes in the Ponseti method. METHODS: We performed a systematic review of comparative studies in which the cast change interval was varied...
2018: PloS One
Ümit Tuhanioğlu, Hasan U Oğur, Fırat Seyfettinoğlu, Hakan Çiçek, Volkan T Tekbaş, Ahmet Kapukaya
BACKGROUND: The aim of this study was to compare the efficacy, advantages, and complications of percutaneous achillotomy in the treatment of clubfoot with the Ponseti method when performed to two different groups under general anesthesia or polyclinic conditions with local anesthesia. METHODS: A retrospective evaluation was made of 96 patients treated for clubfoot in our clinic between January 2013 and June 2016. Fifty-seven patients were separated into two groups according to whether the achillotomy was performed in polyclinic conditions with local anesthesia or under general anesthesia following serial plaster casting with the Ponseti method...
June 19, 2018: Journal of Orthopaedic Surgery and Research
Veroniek M van Praag, Magdalena Lysenko, Barbara Harvey, Rosanna Yankanah, James G Wright
BACKGROUND: Up to 40% of patients with idiopathic clubfoot who are treated with the Ponseti method experience recurrence of deformity. Many of these patients receive surgery (e.g., anterior tibial tendon transfer). An alternative approach for recurrent clubfoot is repeat Ponseti casting. The purpose of this study was to evaluate the outcome of repeat Ponseti casting in the treatment of recurrent clubfoot. METHODS: Patients with recurrent idiopathic clubfoot who were treated at our hospital, between 2004 and 2012, with repeat serial casting and bracing (the recurrent group) were eligible for inclusion in the study...
June 20, 2018: Journal of Bone and Joint Surgery. American Volume
Tristram A Lett, Sebastian Mohnke, Till Amelung, Eva J Brandl, Kolja Schiltz, Alexander Pohl, Hannah Gerwinn, Christian Kärgel, Claudia Massau, Gilian Tenbergen, Matthias Wittfoth, Jonas Kneer, Klaus M Beier, Martin Walter, Jorge Ponseti, Tillmann H C Krüger, Boris Schiffer, Henrik Walter
Pedophilia is a heterogeneous disorder for which the neurobiological correlates are not well established. In particular, there are no biological markers identifying individuals with high risk to commit child sexual offense (CSO). Pedophiles with CSO (P+CSO; N = 73), pedophiles without CSO (P-CSO; N = 77), and non-pedophilic controls (NPC; N = 133) were assessed using multimodal structural neuroimaging measures including: cortical thickness (CT), surface area (SA), and white matter fractional anisotropy (FA), as well as full scale IQ (FSIQ) performance...
June 4, 2018: European Neuropsychopharmacology: the Journal of the European College of Neuropsychopharmacology
Inka Ristow, Meng Li, Lejla Colic, Vanessa Marr, Carina Födisch, Felicia von Düring, Kolja Schiltz, Krasimira Drumkova, Joachim Witzel, Henrik Walter, Klaus Beier, Tillmann H C Kruger, Jorge Ponseti, Boris Schiffer, Martin Walter
A pedophilic disorder is characterised by abnormal sexual urges towards prepubescent children. Child abusive behavior is frequently a result of lack of behavioral inhibition and current treatment options entail, next to suppressing unchangeable sexual orientation, measures to increase cognitive and attentional control. We tested, if in brain regions subserving attentional control of behavior and perception of salient stimuli, such inhibition deficit can be observed also on the level of inhibitory neurotransmitters...
2018: NeuroImage: Clinical
Jurre H Stouten, Arnold T Besselaar, M C Marieke Van Der Steen
Background and purpose - The Ponseti treatment is successful in idiopathic clubfoot. However, approximately 11-48% of all clubfeet maintain residual deformities or relapse. Early treatment, which possibly reduces the necessity for additional surgery, requires early identification of these problematic clubfeet. We identify deformities of residual/relapsed clubfeet and the treatments applied to tackle these deformities in a large tertiary clubfoot treatment center. Patients and methods - Retrospective chart review of patients who visited our clinic between 2012 and 2015 focused on demographics, deformities of the residual/relapsed clubfoot, and applied treatment...
May 30, 2018: Acta Orthopaedica
Anil Agarwal, Anuj Rastogi
INTRODUCTION: We measured the foot dimensions in the Ponseti treated idiopathic clubfeet to compare differences in foot sizes, if any. PATIENT AND METHODS: The foot length and width in unaffected, unilateral and bilateral clubfeet were measured and analysed statistically. RESULTS: Average follow up was 22.2 months. Bilateral feet were similar in size. The unilateral affected feet matched in size with contralateral unaffected feet. The size difference between bilateral and unilateral affected feet was not significant...
2018: SICOT-J
Silvia D Vaca, Nicholus M Warstadt, Isidor H Ngayomela, Rachel Nungu, Emmanuel S Kowero, Sakti Srivastava
In total, 80% of clubfoot cases occur in low- and middle-income countries, where lack of clinical knowledge of the Ponseti method of treatment presents as a major barrier to treatment. This study aims to determine the effectiveness of an electronic learning course to teach clinicians in Tanzania Ponseti method theory. A total of 30 clinicians were recruited from clinics with high referral rates for clubfoot patients and invited to 1 of 3 training sites: Mbeya (n = 15), Zanzibar (n = 10), and Mwanza (n = 5)...
January 2018: Journal of Medical Education and Curricular Development
Lewis Agius, Angus Wickham, Cameron Walker, Joshua Knudsen
BACKGROUND: Percutaneous Achilles tenotomy (PAT) is performed during the final phase of casting with Ponseti method. Several settings have been proposed as venues for this procedure, however it is increasingly being performed in theatre under a general anaesthetic (GA). General anaesthesia, however, is expensive and not without risks. The purpose of the present study was to compare results of outpatient releases to theatre releases, and assess current practising trends among orthopaedic surgeons...
May 18, 2018: New Zealand Medical Journal
Anil Agarwal, Nargesh Agrawal, Sitanshu Barik, Neeraj Gupta
INTRODUCTION: Evidences suggest that different subgroups of idiopathic clubfoot exist with differences in severity and treatment outcomes. This study compares the severity and treatment outcomes of unilateral and bilateral clubfoot. MATERIAL AND METHODS: We retrospectively studied 161 patients (bilateral 66, unilateral 95) with primary idiopathic clubfeet to evaluate the differences in severity and treatment. The parameters analyzed were precasting Pirani score, number of casts required, pretenotomy Pirani score, pretenotomy dorsiflexion, rate of tenotomy, and post-tenotomy dorsiflexion achieved...
May 2018: Journal of Orthopaedic Surgery
Dan Ionuţ Cosma, Andrei Corbu, Dan Viorel Nistor, Adrian Todor, Madalina Valeanu, Jose Morcuende, Sorin Man
PURPOSE: The aim of the study was to evaluate the role of joint hyperlaxity (by Beighton score) as a protective factor for clubfoot relapse. METHODS: Patients with idiopathic clubfoot treated with the Ponseti method between January 2004 and December 2012, without other congenital foot deformity, and not previously treated by open surgery were included in either the Relapse group (n = 23) if it was a clubfoot relapse or the Control group (n = 19) if no relapse was noted...
May 7, 2018: International Orthopaedics
A Sharma, S Shukla, B Kiran, S Michail, M Agashe
Introduction: We assessed the role of the Pirani score in determining the number of casts and its ability to suggest requirement for tenotomy in the management of clubfoot by the Ponseti method. Materials and Methods: Prospective analysis of 66 (110 feet) cases of idiopathic clubfoot up to one year of age was done. Exclusion criteria included children more than one year of age at the start of treatment, non-idiopathic cases and previously treated or operated cases. Results: The initial Pirani score was (5.5±0...
March 2018: Malaysian Orthopaedic Journal
Lewis E Zionts, Edward Ebramzadeh, Rebecca D Morgan, Sophia N Sangiorgio
BACKGROUND: Developed at the University of Iowa in 1950, the Ponseti method to manage idiopathic clubfoot deformity was slow to gain wide acceptance until the mid-1990s. There is a paucity of intermediate and long-term outcome studies involving this technique, with nearly all such studies coming from a single institution. The purpose of this study is to report the contemporary outcome of patients with clubfoot deformity whose feet were managed with the Ponseti method and who were followed to ≥5 years old, to provide outcome expectations for parents and for clinicians managing patients with idiopathic clubfoot...
May 2, 2018: Journal of Bone and Joint Surgery. American Volume
Chao Xu, Jie Wei, Ya-Bo Yan, Lei Shang, Xiao-Jiang Yang, Lu-Yu Huang, Wei Lei
Recent trends have led to an interest in Ponseti treatment for correcting neglected congenital clubfoot. Although good clinical and functional outcomes have been reported, the plantar pressure distribution after the treatment of neglected clubfoot has not been explored yet. The present study aimed to investigate whether plantar pressures normalized following Ponseti treatment in patients with neglected congenital clubfoot. Pedobarographic, clinical, and functional examinations were performed in 22 children (aged, 91...
April 19, 2018: Scientific Reports
Rohit Malhotra, Ashutosh Mohapatra, Geetika Arora, Priyam Choudhury, Hitesh Joshi, Pranav Patel
Congenital talipes equinovarus (CTEV), also known as clubfoot, is a complex congenital deformity of the foot that, left untreated, can limit a person's mobility by making it difficult and painful to walk. Worldwide, 80% of children born with clubfoot are in low- and middle-income countries. The management of clubfoot has a long history. Non-operative management did not become popular, as an increasing number of orthopaedists started leaning towards surgical treatment. The late Dr. Ignacio Ponseti developed a method of clubfoot correction that successfully realigns clubfoot in infants without extensive and major surgery...
April 10, 2018: Children
Hannah Gerwinn, Simone Weiß, Gilian Tenbergen, Till Amelung, Carina Födisch, Alexander Pohl, Claudia Massau, Jonas Kneer, Sebastian Mohnke, Christian Kärgel, Matthias Wittfoth, Stefanie Jung, Krassimira Drumkova, Kolja Schiltz, Martin Walter, Klaus M Beier, Henrik Walter, Jorge Ponseti, Boris Schiffer, Tillmann H C Kruger
Contrary to public perception, child sex offending (CSO) and paedophilia are not the same. Only half of all cases of CSO are motivated by paedophilic preference, and a paedophilic preference does not necessarily lead to CSO. However, studies that investigated clinical factors accompanying and contributing to paedophilia so far mainly relied on paedophiles with a history of CSO. The aim of this study was to distinguish between factors associated with sexual preference (paedophile versus non-paedophile) and offender status (with versus without CSO)...
April 3, 2018: European Psychiatry: the Journal of the Association of European Psychiatrists
Manuele Lampasi, Caterina Novella Abati, Camilla Bettuzzi, Stefano Stilli, Giovanni Trisolino
PURPOSE: The Dimeglio and the Pirani scores are largely used to rate clubfoot at presentation and monitor correction. To date, the accuracy of these scores in predicting appropriate treatment is controversial. The aim of this study was to investigate the accuracy of Dimeglio and Pirani scores in predicting the number of casts and the need for tenotomy in clubfoot correction using the Ponseti method. METHODS: Ninety-one consecutive feet (54 patients; mean age at presentation: 28 ± 15 days) undergoing clubfoot correction using the Ponseti method were prospectively followed from first casting to correction...
March 29, 2018: International Orthopaedics
Massimiliano Dragoni, Armando Gabrielli, Pasquale Farsetti, Diego Bellini, Pierluigi Maglione, Ernesto Ippolito
In our study, we aimed to demonstrate whether a complex iatrogenic clubfoot really exists; identify the causative mechanisms; and determine the outcome if properly treated. We observed 54 clubfeet previously treated unsuccessfully by manipulation and casting elsewhere. All the feet had been classified at diagnosis as typical clubfeet. In 26 cases, the cast had slipped down, entrapping the foot in a plantar-flexed position. Nine clubfeet out of those 26 cases presented the clinical features of a complex iatrogenic deformity...
March 23, 2018: Journal of Pediatric Orthopedics. Part B
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