Early radiographic risk factors for rigid relapse in idiopathic clubfoot treated with the Ponseti method

被引：6

作者：

Mishima, Kenichi ^{[1
]}

Kitoh, Hiroshi ^{[1
]}

Matsushita, Masaki ^{[1
]}

Sugiura, Hiroshi ^{[1
]}

Hasegawa, Sachi ^{[1
]}

Kitamura, Akiko ^{[1
]}

Nishida, Yoshihiro ^{[1
]}

Ishiguro, Naoki ^{[1
]}

机构：

[1] Nagoya Univ, Grad Sch Med, Dept Orthopaed Surg, Showa Ku, 65 Tsurumai Cho, Nagoya, Aichi 4668550, Japan

来源：

FOOT AND ANKLE SURGERY | 2018年 / 24卷 / 06期

关键词：

Clubfoot; onseti method; Relapse; Early risk factor; Radiographic measurement; Achilles tenotomy; Soft-tissue release; PERCUTANEOUS ACHILLES TENOTOMY; CLUBFEET; FOOT; MANAGEMENT; NEED;

D O I：

10.1016/j.fas.2017.06.003

中图分类号：

R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学（修复外科学）];

学科分类号：

摘要：

Background: This study aimed at identifying early risk factors for rigid relapse in idiopathic clubfoot using foot radiographs. Methods: Thirty-four patients with 43 idiopathic clubfeet treated with the Ponseti method were retrospectively reviewed. Results: There were seven rigid relapse recalcitrant to manipulation and requiring extensive soft-tissue release. Three radiograabphic measurements on the maximum dorsiflexion lateral (MD-Lat) radiograph, talocalcaneal (TaloCalc-Lat), tibiocalcaneal (TibCalc-Lat), and calcaneus-first metatarsal (CalcMT1-Lat) angles, showed significant differences between patients with and without rigid relapse. The TaloCalc-Lat and CalcMT1-Lat angles showed significant hazard ratio for rigid relapse by multivariate survival analysis. Clubfeet demonstrating TibCalc-Lat > 90 degrees and CalcMT1-Lat < 5 degrees have a 24.9-fold odds ratio to develop rigid relapse compared to those demonstrating TibCalc-Lat <= 90 degrees or CalcMT1-Lat >= 5 degrees. Conclusions: The TaloCalc-Lat, TibCalc-Lat, and CalcMT1-Lat angles on the MD-Lat radiograph immediately before the tenotomy, probably representing intrinsic tightness of the midfoot and/or hindfoot, are significant risk factors for rigid relapse in patients treated with the Ponseti method. (C) 2017 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.

引用

页码：509 / 513

页数：5

共 24 条

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