ALGORITHM OF TREATMENT OF CONGENITAL CLUBFOOT IN CHILDREN OF YOUNGER AGE GROUP

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Abstract

Congenital clubfoot requires complete correction before the period of verticalization. Conservative methods are priority in treatment. The most effective method is Ponseti method that allows correcting all the deformations even in severe clubfoot. However, if clubfoot is accompanied with abnormal anatomy of foot or significant changes in functional ability of muscles, operative treatment is inevitable. The extent of surgical intervention depends on the severity of detected abnormalities and is determined individually. The use of ultasound, radiographic, and CT investigations, according to indications, contributes to the diagnostics. The indication for surgery is the lack of effect of conservative treatment after 10-12 cast correction in children over the age of 4 months. Diagnostic criteria for deciding in favor of surgery are: availability of fibrous coalition, the deformation of the talar or the sphenoid bone, the anomaly in the point of attachment of the tendon of the tibialis anterior muscle, lack of the repositioning of navicular bone on the talar head. Orthosis supply and rehabilitation treatment depend on the extent of surgical intervention.

About the authors

Irina Yurievna Klychkova

FSBI “Scientific and Research Institute for Children’s Orthopedics n. a. H. Turner” of Health Ministry of the Russian Federation

Email: Klychkova@yandex.ru
Ph.D, chief of the department of foot pathology, neuroorthopedics and systemic

Vladimir Markovich Kenis

FSBI “Scientific and Research Institute for Children’s Orthopedics n. a. H. Turner” of Health Ministry of the Russian Federation

Email: kenis@mail.ru
Ph.D, scientific advisor of the department of foot pathology, neuroorthopedics and systemic diseases

Yulia Alexandrovna Stepanova

FSBI “Scientific and Research Institute for Children’s Orthopedics n. a. H. Turner” of Health Ministry of the Russian Federation

Email: turner01@mail.ru
orthopedic surgeon of the department of foot pathology, neuroorthopedics and systemic diseases

Andrey Victorovich Sapogovskiy

FSBI “Scientific and Research Institute for Children’s Orthopedics n. a. H. Turner” of Health Ministry of the Russian Federation

Email: turner01@mail.ru
orthopedic surgeon of the department of foot pathology, neuroorthopedics and systemic diseases

Nadezhda Alexandrovna Kovalenko-Klychkova

FSBI “Scientific and Research Institute for Children’s Orthopedics n. a. H. Turner” of Health Ministry of the Russian Federation

Email: turner01@mail.ru
orthopedic surgeon of the department of foot pathology, neuroorthopedics and systemic diseases

Stanislav Vyacheslavovich Ivanov

FSBI “Scientific and Research Institute for Children’s Orthopedics n. a. H. Turner” of Health Ministry of the Russian Federation

Email: turner01@mail.ru
research associate of the department of foot pathology, neuroorthopedics and systemic diseases

References

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  6. Morcuende J. A., Dobbs M. B., Frick S. L. Results of the Ponseti method in patients with clubfoot associated with arthrogryposis // Iowa Orthop J. 2008. № 28. Р. 22-26.
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Copyright (c) 2013 Klychkova I.Y., Kenis V.M., Stepanova Y.A., Sapogovskiy A.V., Kovalenko-Klychkova N.A., Ivanov S.V.

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