Runu Ritesh, Kashyap Nishant, Subhash Abhijeet, Lall Shweta
Department of Orthopaedics, IGIMS, Patna, Bihar, India.
Department of Endodontics, Dr. BR Ambedkar Dental College, Patna, Bihar, India.
J Orthop Case Rep. 2022 Feb;12(2):1-4. doi: 10.13107/jocr.2022.v12.i02.2640.
Non-idiopathic clubfeet are more rigid compared to idiopathic clubfeet and usually require operative correction. Recent reports favor Ponseti casting in these feet. Iatrogenic fractures during and after casting have been reported in the literature but epiphyseal separation and subperiosteal ossification have not been reported earlier.
A3-year-old female child presented with untreated bilateral clubfeet and lumbosacral myelomeningocele. She was treated by Ponseti casting. During the casting session, we noticed swelling and deformity in the left leg and feet. After X-ray, distal tibial, fibular epiphyseal separation, and displacement were noticed. She was treated by manipulation and casting and final correction achieved by bilateral tendoachilles tenotomy.
Ponseti casting for non-idiopathic clubfeet may develop epiphyseal displacement of distal tibia and fibula; hence, any abnormal swelling and deformity need to be evaluated by radiograph.
与特发性马蹄内翻足相比，非特发性马蹄内翻足更为僵硬，通常需要手术矫正。近期报告支持对这类足部进行庞塞蒂石膏疗法。文献中已报道过石膏治疗期间及之后发生的医源性骨折，但此前尚未报道过骨骺分离和骨膜下骨化。
一名3岁女童患有未经治疗的双侧马蹄内翻足和腰骶部脊髓脊膜膨出。她接受了庞塞蒂石膏疗法。在石膏治疗过程中，我们注意到左腿和足部出现肿胀及畸形。经X线检查后，发现胫腓骨远端骨骺分离及移位。她接受了手法复位和石膏固定治疗，最终通过双侧跟腱切断术实现矫正。
对非特发性马蹄内翻足进行庞塞蒂石膏疗法可能会导致胫腓骨远端骨骺移位；因此，任何异常肿胀及畸形均需通过X线片进行评估。
