Abstract
Wrist arthrodesis is commonly performed to improve wrist position, flexion crease hygiene and appearance in patients with spastic upper limbs. These patients often have smaller bones and large commercially available implants lead to complications such as prominence of plate, pain and periprosthetic fractures. Authors hypothesized that Medartis® distal radius plates will lead to lower complication rates on account of lower profile, variable angle locking construct and smaller screw size.
Highlights
Clubfoot is the commonest congenital orthopedic defect, but still remains unsolved
Author published in International Orthopaedics (SICOT), a new surgical concept, treating 95% relapses/under-corrections in trimorphic extreme clubfoot deformities [1]
The completed cast has been named as Below Knee (BK) Hoody cast or Cobra Hood cast due to its resemblance with it (Figure 2)
Summary
None of the contemporary conservative methods of treatment have taken into consideration the polymorphism of clubfoot, from ankle to toes and are not inclusive treatments [3,4,5,6] Author innovated this highly acceptable, evidence based, all- inclusive, manipulation and casting technique, to prevent under-corrections and relapses. If the deformity gets corrected early before the walking age, a custom-fit, low cost, single or double posterior plaster mold (in bilateral cases) in overcorrected position are advised, till the child starts walking. If we want good correction in every case, they do need a different conservative approach than mild and moderate cases to prevent relapses and under-corrections from contemporary techniques as reported in literature Evolution of this technique is based on the polyarticular/polymorphic pathoanatomy of the extreme deformities, prevalent at birth, as stated above. Similar forces of normal weight bearing keep the deformity corrected, by natural static and dynamic mechanics and modified shoes, further supplement these forces
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