Pavone Vito, Sapienza Marco, Vescio Andrea, Caldaci Alessia, McCracken Kathryn Louise, Canavese Federico, Testa Gianluca
Department of General Surgery and Medical Surgical Specialties, Section of Orthopaedics and Traumatology, P.O. "Policlinico Gaspare Rodolico", University of Catania, Catania, Italy.
Department of Pediatric Orthopedic Surgery, Jeanne de Flandre Hospital, Lille University Centre, Lille, France.
Front Pediatr. 2022 Aug 24;10:869401. doi: 10.3389/fped.2022.869401. eCollection 2022.
Idiopathic clubfoot, also referred to as congenital talipes equinovarus (CTEV), is one of the most common lower limb deformities observed in newborns, leading to significant functional impairment if untreated. The aims of this study were to (1) assess the developmental milestones in patients with CTEV treated by the Ponseti technique, and to compare them to the unaffected controls; (2) evaluate the possible correlation between developmental milestones, severity of the deformity, and number of casts.
Seventy-nine subjects were divided into two groups, CTEV group (43 patients; 72 feet) and control group (36 patients). Age, sex, affected side, attainment of babbles (BAL), independent gait (IG), and combined word (CW) were recorded for all patients. In patients with CTEV, Pirani Score (PRS), number of casts (NC), and clinical outcome were collected according to the Clubfoot Assessment Protocol (CAP), The American Orthopedic Foot and Ankle Score (AOFAS), and Foot and Ankle Disability Index (FADI).
IG was achieved later later than the unaffected controls by 12/43 patients (27.9%) with CTEV and 3/36 patients in the control group (8.3%) ( = 0.04) and in a mean time of 16.8 ± 3.5 months and 13.2 ± 2.7 months, respectively ( = 0.001). In the CTEV group the mean value of CAP was 98.6 ± 4.7, of AOFAS of 98.4 ± 4.4 and of FADI equal to 99.9 ± 0.44. There were no statistically significant differences for BAL and CW; and no correlation with PRS, NC, or clinical score were identified.
CTEV patients managed by the Ponseti technique achieve independent gait later than the unaffected controls, although they do so within the age limit of developmental. On the other hand, the Ponseti treatment has no impact on attainment of language development.
特发性马蹄内翻足，也称为先天性马蹄内翻足（CTEV），是新生儿中最常见的下肢畸形之一，若不治疗会导致严重的功能障碍。本研究的目的是：（1）评估采用庞塞蒂技术治疗的CTEV患者的发育里程碑，并与未受影响的对照组进行比较；（2）评估发育里程碑、畸形严重程度和石膏固定次数之间的可能相关性。
79名受试者分为两组，CTEV组（43例患者；72只脚）和对照组（36例患者）。记录所有患者的年龄、性别、患侧、咿呀学语（BAL）、独立步态（IG）和组合词（CW）情况。对于CTEV患者，根据马蹄内翻足评估方案（CAP）、美国矫形足踝评分（AOFAS）和足踝残疾指数（FADI）收集皮拉尼评分（PRS）、石膏固定次数（NC）和临床结果。
12/43例（27.9%）CTEV患者和3/36例（8.3%）对照组患者的IG实现时间晚于未受影响的对照组（P = 0.04），平均时间分别为16.8±3.5个月和13.2±2.7个月（P = 0.001）。CTEV组CAP的平均值为98.6±4.7，AOFAS为98.4±4.4，FADI等于99.9±0.44。BAL和CW无统计学显著差异；未发现与PRS、NC或临床评分有相关性。
采用庞塞蒂技术治疗的CTEV患者实现独立步态的时间晚于未受影响的对照组，尽管是在发育年龄范围内。另一方面，庞塞蒂治疗对语言发育的实现没有影响。
