Niedzielski Kryspin Ryszard, Małecki Krzysztof, Kosińska Małgorzata, Lipczyk Zbigniew
Klinika Ortopedii i Traumatologii z Pododdziałem Chirurgii Reki dla Dzieci Instytutu Centrum Zdrowia Matki Polki w Łodzi.
Chir Narzadow Ruchu Ortop Pol. 2011 Sep-Oct;76(5):247-51.
Congenital clubfoot is one of the most common congenital skeletal defects. Its aetiology remains unclear. Due to its high incidence and social consequences, the therapy of congenital clubfoot presents an important medical issue. Non-surgical treatment methods are preferred. Many publications confirmed the efficacy of the Ponseti method. The aim of this study was to present early results of congenital clubfoot treatment using the Ponseti method in a one-year follow-up. The therapy protocol was in accordance with guidelines presented by the inventor. The necessity of surgical treatment was a criterion for negative treatment outcome. One hundred and sixteen feet of 92 children were analysed. A Dimeglio-Bensahel classification was used for the evaluation of the defect advance. Seventy-one feet (61.2%) were assessed as grade II, 43 feet as grade III (37.1%) and 2 feet as grade IV deformation. No patients with grade I deformation were included into the study. A positive treatment outcome was observed for 96 feet (82.7%), whereas a negative result for the remaining 20 feet (17.3%). Our results are therefore not consistent with the literature data. It could have resulted from the too precipitate qualification for surgery by the physician and problems with compliance. The Ponseti method is an effective and less straining treatment modality of the congenital clubfoot. In most cases it allows for avoiding extensive surgery and associated complications. A necessity of wearing an orthosis and a risk treatment failure, if not worn systematically, should be emphasised. A longer follow-up period is required for complete result analysis.
先天性马蹄内翻足是最常见的先天性骨骼缺陷之一。其病因尚不清楚。由于其高发病率和社会影响,先天性马蹄内翻足的治疗成为一个重要的医学问题。非手术治疗方法更受青睐。许多出版物证实了庞塞蒂方法的有效性。本研究的目的是呈现使用庞塞蒂方法治疗先天性马蹄内翻足一年随访的早期结果。治疗方案符合发明者提出的指南。手术治疗的必要性是治疗结果为阴性的标准。对92名儿童的116只脚进行了分析。采用迪梅吉奥 - 本萨赫尔分类法评估畸形进展情况。71只脚(61.2%)被评估为II级,43只脚为III级(37.1%),2只脚为IV级畸形。研究未纳入I级畸形患者。96只脚(82.7%)观察到治疗结果为阳性,其余20只脚(17.3%)为阴性。因此,我们的结果与文献数据不一致。这可能是由于医生过早确定手术适应症以及依从性问题导致的。庞塞蒂方法是一种治疗先天性马蹄内翻足的有效且负担较小的治疗方式。在大多数情况下,它可以避免广泛的手术及相关并发症。应强调佩戴矫形器的必要性以及如果不系统佩戴可能导致治疗失败的风险。需要更长的随访期来进行完整的结果分析。