2004 Pediatric Orthopedic Society of North America Convention

[Guest guest]

The Pediatric Orthopedic Society of North America will have it's

annual convention April 28 to May 1, 2004 in St. Louis, Missouri.

The following is the abstract of the paper presented by the

University of Iowa.

CLUBFOOT RELAPSES WITH THE PONSETI METHOD:

EFFECT OF HYPER-ABDUCTION AND LONG-TERM BRACING

JA Morcuende, MD, PhD; CD lein, BS;

S Fuchs, MD; D Abbasi, BS; LA Dolan, PhD©; and IV Ponseti, MD

The initial published results of the Ponseti method (1963)

demonstrated excellent clubfoot corrections, but there were a high

number of relapses and anterior tibialis transfers. The purpose of

this study was to evaluate the effect of hyperabduction and long-

term bracing in reducing relapse and surgery rates.

We reviewed 235 patients with idiopathic clubfoot (374 feet) treated

since 1992. 156 patients were male (67%). Age at presentation was: 0-

3 months: 124 patients; 3-6 months: 60 patients; >6 months: 51

patients. 168 patients had previous treatment elsewhere, including

35 patients who had an Achilles tenotomy. All patients were treated

as described by Ponseti, but with hyperabduction (70 degrees) in the

last cast and bracing up to 4 years of age.

Clubfoot correction was successful in all but 4 patients. 89% of

patients required £5 casts for correction. Percutaneous Achilles

tenotomy was performed in 81% of patients (resulting mean

dorsiflexion of 18 degrees). There were 24 (10%) relapses. Relapses

were related to non-compliance with the brace (p<0.0001). Age at

presentation, previous treatment, or number of casts required for

correction were not significant. Only 13 patients (5%) required

surgery (1 PMR, 3 PR, 2 TAL+ATT+PR, and 7 TAL+ATT).

Obtaining hyperabduction in the last cast and the long-term bracing

have a very significant effect on relapses and surgeries for

clubfoot.

The Ponseti method is a very efficient treatment for the correction

of idiopathic clubfoot.

> The Pediatric Orthopedic Society of North America will have it's

> annual convention April 28 to May 1, 2004 in St. Louis, Missouri.

> They papers that are being presented on Clubfoot treatment are as

> follows.

>

> Friday, April 30, 2004

> 7:40 AM - 7:45 AM - Announcements

> Presider: Myers, MD

> Moderator: Lori Karol, MD

>

> 7:45 AM - 7:49 AM - Prospective Study of Idiopathic Clubfeet

> Comparing the Ponseti and French PT Methods - Early Results

> B s, MD (n); C E ston, MD (n); S Faulks (n); H

> (n)

>

> 7:50 AM - 7:54 AM - Anesthesia for Infants Undergoing Ponseti

> Achilles Tenotomy

> E Herzenberg, MD (n); Noam Bor, MD (n); Yeshayahu Katz, MD

(n);

> Oded Vofsi, MD (n); L Zuckerberg (n)

>

> 7:55 AM - 7:59 AM - Clubfoot Relapses With The Ponseti Method:

> Effect Of Hyperabduction And Long-Term Bracing

> A Morcuende, MD, PhD (n); Christian lein, BS (n);

ne

> Fuchs, MD (n); Abbasi, BS (n); Lori Dolan, PhD© (n);

Ignacio

> V. Ponseti, MD (n)

>

> 8:00 AM - 8:09 AM - Discussion

>

> 8:10 AM - 8:14 AM - A Reliable and Valid Method of Assessing the

> Amount of Deformity in the Congenital Clubfoot

> Shafique P Pirani, FRCSC (n); Hodges, FRCP (n); Floyd

> Sekeramayi, MBBS (n)

>

> 8:15 AM - 8:19 AM - A Minimum 25-Year Follow-Up Of Idiopathic

> Clubfoot Patients Treated With An Extensive Soft-Tissue Release

> Operation As Infants

> B Dobbs, MD (n); L Schoenecker, MD (n)

>

> 8:20 AM - 8:24 AM - Clubfoot Reconstruction: Radiographic Results

> Versus Patient Functional and Satisfaction Outcomes

> D Aronsson, MD (n); Shuriz Hishmeh, PT (n)

>

> 8:25 AM - 8:29 AM - Prevention of Recurrence of Clubfoot by

> Aggressive Hindfoot Realignment: Ten Year Outcomes

> G Ehrlich, MD (n); Ralph F Henn, BS (n); Dennis C

Crawford,

> MD, PhD (n); Craig P Eberson, MD (n)

>

> http://www.posna.org/index?

> service=page&context=scientific2004AtAGlance

>

> and (3-17-99)