Vaishy Arun K, Arif Mohd, Acharya Deepshikhar, Choudhary Ramakishan, Seervi Prem M, Kumar Ravi
Department of Orthopaedics, S N Medical College, Jodhpur, India.
Present Address: Jodhpur, India.
Indian J Orthop. 2020 Jan 24;54(1):55-59. doi: 10.1007/s43465-019-00004-6. eCollection 2020 Feb.
The clubfoot is one of the commonly found congenital deformities in newborn. The Ponseti method is the most effective nonoperative clubfoot management method. It is based on understanding of pathoanatomy of clubfoot. For classifying severity of clubfoot, Pirani score is used. The number of cast required for clubfoot correction is dependent on its initial Pirani score. This study aimed on how the number of cast for correction of clubfoot deformity depends on starting time of casting and pretreatment Pirani score.
This study comprises of 200 patients with 297 affected foot nonoperatively managed with Ponseti technique of casting. We measured initial and final Pirani scores of patients with different age groups.
We found that initial severity was less in 0-1 month age group children but mean casting number was more while initial severity was more in 1-2 month age group, the mean number of casting was less. Tenotomy requirement was also less in 1-2 month age group.
We concluded that casting according to the Ponseti method should be started in 1-2 months age group which shows better results than the other age groups in clubfoot.
马蹄内翻足是新生儿常见的先天性畸形之一。庞塞蒂方法是最有效的非手术治疗马蹄内翻足的方法。它基于对马蹄内翻足病理解剖的认识。为了对马蹄内翻足的严重程度进行分类，采用皮拉尼评分。矫正马蹄内翻足所需的石膏固定次数取决于其初始皮拉尼评分。本研究旨在探讨马蹄内翻足畸形矫正所需的石膏固定次数如何取决于石膏固定开始时间和治疗前的皮拉尼评分。
本研究纳入200例患者共297只患足，采用庞塞蒂石膏固定技术进行非手术治疗。我们测量了不同年龄组患者的初始和最终皮拉尼评分。
我们发现，0至1月龄儿童的初始严重程度较低，但平均石膏固定次数较多；而1至2月龄儿童的初始严重程度较高，平均石膏固定次数较少。1至2月龄组的跟腱切断术需求也较少。
我们得出结论，对于马蹄内翻足，按照庞塞蒂方法进行石膏固定应在1至2月龄组开始，该组比其他年龄组显示出更好的治疗效果。
