Comparative analysis of weight-bearing function of lower extremities in children with recurrences of congenital equinovarus clubfoot after surgical treatment by «traditional» methods and Ponseti method

Authors

  • Sergij Khmyzov Sytenko Institute of Spine and Joint Pathology National Academy of Medical Sciences of Ukraine, Kharkiv, Ukraine https://orcid.org/0000-0002-6725-0915
  • Genadij Kykosh Sytenko Institute of Spine and Joint Pathology National Academy of Medical Sciences of Ukraine, Kharkiv, Ukraine
  • Olena Karpinska Sytenko Institute of Spine and Joint Pathology National Academy of Medical Sciences of Ukraine, Kharkiv, Ukraine https://orcid.org/0000-0002-1482-7733
  • Mykhaylo Karpinsky Sytenko Institute of Spine and Joint Pathology National Academy of Medical Sciences of Ukraine, Kharkiv, Ukraine https://orcid.org/0000-0001-7919-4124

DOI:

https://doi.org/10.15674/0030-5987202119-17

Keywords:

Congenital talipes equinovarus, children, Ponseti method, statography

Abstract

Congenital equinovarus clubfoot (EVC) is the second most common congenital anomaly of the musculoskeletal system in children and one of the most common causes of childhood disability in Ukraine. The frequency of EVC reaches 1–3 cases per 1 000 newborns (35–40 % of all foot deformities). Objective. To determine the features of the children ability with EVC recurrences, before and after surgical treatment by «traditional» methods and Ponseti method. Methods. Biomechanical examinations of 65 children with EVC recurrences were performed. They were divided into two groups: group I (33 patients) — treated by «traditional» methods, which provided initial surgery, in order to completely correct all components of the deformity; group II (32 patients) — treatment by Ponseti method. Weight-bearing function was studied for all patients, before treatment, after 6 and 12 months after surgery, with statography. Results. It was determined that the standing parameters in the groups were not statistically different. After 6 months after the treatment, according to the statograms, the weight-bearing displacement remained, under the conditions of two weight-bearing standing towards the contralateral limb, in both groups of patients. In group I, after treatment, this parameter did not change (p = 0.924), and in group II it decreased by (2.7 ± 4.7) % (p = 0.013). Weight-bearing on the operated limb in both groups, in 12 months from surgery increased by 45 %. Conclusions. In patients, after treatment of EVC recurrences by Ponseti method, the weight-bearing function indicators, in the case of two weight-bearing standing, changed statistically significant. During the recovery process, when patients began to load the operated foot, a slight deterioration of standing parameters was observed in patients of group I in 6 months from surgery. In patients of group II, a complete restoration of statographic parameters occurred earlier, in 6 months, a normalization of weight-bearing and stability was observed. Thus, it can be argued that the use of Ponseti method in the complex treatment of EVC allows to restore the ability of weight bearing much earlier than with the «traditional» method. Key words. Congenital talipes equinovarus, children, Ponseti method, statography.

Author Biographies

Sergij Khmyzov, Sytenko Institute of Spine and Joint Pathology National Academy of Medical Sciences of Ukraine, Kharkiv

MD, Prof. in Traumatology and Orthopaedics

Genadij Kykosh, Sytenko Institute of Spine and Joint Pathology National Academy of Medical Sciences of Ukraine, Kharkiv

PhD in Traumatology and Orthopaedics

References

  1. Ponseti, I. V., & Smoley, E. N. (2009). The classic: Congenital club foot: The results of treatment. Clinical Orthopaedics & Related Research, 467(5), 1133-1145. https://doi.org/10.1007/s11999-009-0720-2
  2. Volkov, S. E. (1999). Differential diagnosis and early complex treatment of congenital deformities of the feet in children. [Unpublished PhD dissertation]. [in Russian]
  3. Hsu, L. P., Dias, L. S., & Swaroop, V. T. (2013). Long-term retrospective study of patients with idiopathic Clubfoot treated with posterior medial-lateral release. Journal of Bone and Joint Surgery, 95(5), e27. https://doi.org/10.2106/jbjs.l.00246
  4. Lampasi, M., Bettuzzi, C., Palmonari, M., & Donzelli, O. (2010). Transfer of the tendon of tibialis anterior in relapsed congenital clubfoot. The Journal of Bone and Joint Surgery. British volume, 92-B(2), 277-283. https://doi.org/10.1302/0301-620x.92b2.22504
  5. Piazza, S. J., Adamson, R. L., Sanders, J. O., & Sharkey, N. A. (2001). Changes in muscle moment arms following split tendon transfer of tibialis anterior and tibialis posterior. Gait & Posture, 14(3), 271-278. https://doi.org/10.1016/s0966-6362(01)00143-6
  6. Henderson, C. P., Parks, B. G., & Guyton, G. P. (2008). Lateral and medial plantar pressures after split versus whole anterior Tibialis tendon transfer. Foot & Ankle International, 29(10), 1038-1041. https://doi.org/10.3113/fai.2008.1038
  7. Hui, J. H., Goh, J. C., & Lee, E. H. (1998). Biomechanical study of Tibialis anterior tendon transfer. Clinical Orthopaedics and Related Research, (349), 249-255. https://doi.org/10.1097/00003086-199804000-00031
  8. Richards, B. S., Johnston, C. E., & Wilson, H. (2005). Nonoperative Clubfoot treatment using the French physical therapy method. Journal of Pediatric Orthopaedics, 25(1), 98-102. https://doi.org/10.1097/01241398-200501000-00022
  9. Alekseeva, O. Yu., & Karpinsky, M. Yu. (2002). Methods of analysis of stabilograms in assessing the functional state of a person. Medicine and ..., 1, 48–53. [in Russian]
  10. Tyazhelov, O. A., Karpinsky, M. Yu., Karpinskaya, O. D., & S. Yu. Yaremin. (2014). Substantiation and analysis of geometric parameters of statograms for assessing the state of the musculoskeletal system of man. Orthopedics, Traumatology and Prosthetics, 3, 62–68. https://doi.org/10.15674 / 0030-59872014362-67. [in Ukrainian]
  11. Tyazhelov, O. A., Karpinsky, M. Yu., Karpinskaya, O. D., & S. Yu. Yaremin. (2014). Features of dynamic characteristics of statograms at fixing of joints of the lower extremity Injury. Trauma, 15(2), 88–93. https://doi.org/10.22141/1608-1706.2.15.2014.81375. [in Ukrainian]
  12. Miteleva, Z. M., Karpinsky, M. Yu., Kokorovets, V. Ya., & Kruzhilin, G. I. (1997). System for a comprehensive assessment of the state of the musculoskeletal and vestibular apparatus of a person «Statograf». Medicine and ..., 1, 35–36. [in Russian]
  13. Aleksandrov, A. V., Frolov, A. A., & Mason, J. (2002). The strategy of maintaining a person’s balance when the body is tilted forward on a narrow support. Russian Journal of Biomechanics, 6(4), 63–77. [in Russian]
  14. Byul, A., & Cefler, P. (2005). SPSS: The Art of Information Processing. Analysis of statistical data and recovery of hidden patterns. SPb.: DiaSoftUP. [in Russian]

How to Cite

Khmyzov, S. ., Kykosh, G. ., Karpinska, O. ., & Karpinsky, M. . (2021). Comparative analysis of weight-bearing function of lower extremities in children with recurrences of congenital equinovarus clubfoot after surgical treatment by «traditional» methods and Ponseti method. ORTHOPAEDICS TRAUMATOLOGY and PROSTHETICS, (1), 9–17. https://doi.org/10.15674/0030-5987202119-17

Issue

Section

ORIGINAL ARTICLES