Cases Of Congenital Talipes Equinovarus Research Articles

An evaluation of congenital talipes equinovarus patients treated by various methods

<p class="abstract"><strong>Background:</strong> Idiopathic congenital talipes equinovarus is one of the commonest congenital anomaly. Although treatment provides many options, near universal agreement exists that initial management should consist of gentle manipulation of the affected foot. In developing country like India presentation is extremely variable from soon after birth to very late childhood and irregular follow up makes treatment more difficult.</p><p class="abstract"><strong>Methods:</strong> 100 cases of congenital talipes equinovarus who attended the Orthopedics OPD of our hospital (March 2013 to 2016) were taken up. In neonates with delicate skin, the passive manipulation was demonstrated to the mother which they did 5-6 times daily. The application of plaster of Paris cast and passive manipulation was done every 15<sup>th</sup> day upto 3 months of age. After the 3-month age, passive manipulation was done every 3 weeks. If no normalization, surgery was advised and done to correct the resistant component accordingly. All the analyses were performed in R-programming language (R- 3.0.0).<strong></strong></p><p class="abstract"><strong>Results:</strong> 6 cases,10 feet were lost during follow-up. Results were assessed in 134 feet, 128 cases managed conservatively, 13 surgically. Results were assessed according to clinical, radiological criteria of Beatson and Pearson. 13 feet were operated of 144 feet,11 cases posteromedial soft tissue release (PMSTR) was done. In two Joshi’s external stabilizing system (JESS) fixator was applied.</p><p class="abstract"><strong>Conclusions:</strong> Majority of cases can be treated successfully by conservative means and only in 11 cases PMSTR was done, 2 cases of relapsed feet JESS was applied.</p>

Study of congenital talipes equinovarus cases and its radiological correlation

Abstract Background and aims : congenital talipes equinovarus (CTEV) or club foot is one of the most common congenital orthopaedic anomalies and is increasing day by day with the growing millions of this country. However, it still continues to challenge the skills of the surgeons as it has a notorious tendency to relapse. Part of the reason behind its relapse is the failure to recognize the underlying pathoanatomy. Again the controversy regarding the radiographic parameter which best represents the deformity of club foot still continues. However, the talocalcaneal angle in both AP (anterior-posterior) and lateral view is considered as the best parameter to diagnose a case of CTEV radio graphically. The aim of the study is to study the cases of CTEV and their radiological correlation. Materials and methods : Sixty cases of CTEV attending the orthopaedic OPD, Gauhati Medical College were taken for study. Clinical history, photographs and radiographs (X-rays) of these cases were taken. Results and observations : out of 60, 63.3% cases were male, 43.3% cases were bilateral, 36.04% cases showed the talocalcaneal angle (AP view) ranging 260 - 300. Conclusion : The talocalcaneal angles, in both, AP (anterior-posterior) and a lateral view, in a normal foot is more than 35 degrees, but in CTEV these are reduced. Functional anatomy of CTEV is a prerequisite for achieving an aligned and supple foot with a good prognostic value.

A clinical study of ligamentoaxis using an external fixator, modified frame in the management of a neglected, relapsed, resistant older congenital Talipes Equino varus child

Background: In an older, relapsed, recurrent, resistant Congenital Talipes Equino Varus (CTEV) child with previous surgical scar, soft tissue release alone is often not sufficient for full correction, particularly at above 2 years of age. Here controlled, fractional differential distraction with Joshi's external stabilization system is a useful option to correct all the deformities. It is a well-established modality but with complication rate of 30%, mainly related to pin loosening and infection leading to instability of frame. We aimed to study a method to increase stability of frame to reduce incidence of pin loosening, infection and to evaluate clinical and functional outcome of the modality along with modification. Materials and Methods: 117 children underwent Joshi's external stabilization system procedure. The principle of correction applied in this study was fractional distraction. Patients were evaluated by Catteral and Simons criteria. Results: Excellent results were obtained in 68.50% of cases, good results in 23.90%, and poor results in 7.60% of the cases. The complication rate reduced to 3% pin tract infections, which eventually healed with outpatient treatment. Conclusion: Fractional distraction method by using Joshi's External Stabilization System is an easy, simple, less invasive method, which corrects all the deformities in resistant, neglected, and relapsed cases of CTEV and modification of the frame we used proved to be beneficial. Teaching and awareness of parents regarding distraction schedule, stability of frame postoperative importance of wearing of corrected footwear for long period are important.

Paralytic congenital talipes equinovarus of unknown origin: A new entity. Multicenter study of 42 cases

Paralysis of the lateral and/or anterior leg muscles can lead to relapse of treated talipes equinovarus. The muscle function impairment is due to isolated permanent paralysis, and early palliative tendon transfer may prevent recurrence of the deformity. Forty-two cases of congenital talipes equinovarus that recurred after conservative therapy were reviewed after a mean follow-up of 10years. In 39cases, second-line surgery was performed (posteromedial release, n=33; and muscle transfer, n=26). Outcomes were evaluated clinically. Separating the cases into two groups, based on whether muscle transfer was performed, showed a statistically significant difference: muscle transfer intended to restore eversion and/or dorsal flexion of the foot was associated with significantly better functional outcomes. In addition to providing etiological insights, the identification of paralysis in patients with talipes equinovarus can influence treatment decisions, depending on the nature of the muscle deficiencies, with the goal of preventing recurrences. Early muscle transfer to restore eversion and/or dorsal flexion of the foot may provide the best functional outcomes by minimizing the need for soft-tissue release. IV, retrospective multicentre study.

The management of congenital talipes equinovarus in developing countries.

Congenital Talipes Equinovarus often remains untreated in developing countries. At our Institute in Calcutta, where we have modern facilities, a programme was undertaken using simple techniques in selected cases. Since 1964, 5,312 cases of congenital talipes equinovarus were treated by percutaneous elongation of the Achilles tendon, plantar fasciotomy and corrective plasters. In 4,502 cases the results are good enough to recommend this technique, even in developed countries.