Nogueira Monica Paschoal, Ey Batlle Anna Maria, Alves Cristina Gomes
Pediatric Orthopaedic Group, Orthopaedics Department, Hospital do Servidor Público Estadual, São Paulo, Brazil.
Clin Orthop Relat Res. 2009 May;467(5):1298-305. doi: 10.1007/s11999-009-0718-9. Epub 2009 Feb 4.
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 IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
庞塞蒂方法治疗马蹄内翻足已在特发性马蹄内翻足中广泛应用，最近也用于一些综合征性马蹄内翻足病因。我们探讨了其能否用于治疗后内侧松解失败后的复发性马蹄内翻足。我们回顾性分析了三个中心采用庞塞蒂方法治疗后内侧松解后复发性畸形的58例儿童（83足）。最短随访时间为24个月（平均45个月；范围24 - 80个月）。我们测定了初始和最终的皮拉尼评分以及踝关节和距下关节的活动范围。71足（86%）获得了足底放平且完全矫正的足；11足获得部分矫正；1例患者治疗失败并接受了再次后内侧松解。9例患者（12足或14%）出现复发。除1例患者外，所有患者的初始皮拉尼评分均有改善；治疗所用石膏的数量也可推断畸形的严重程度。治疗时的年龄和石膏数量并未影响皮拉尼等人的评分。三位骨科医生的评分相似。
IV级，治疗性研究。有关证据级别的完整描述，请参见作者指南。
