Henri BENSAHEL, Pascal JEHANNO, Jean-Pierre DELABY, Christine THEMAR-NOEL

Çarpık ayağın konservatif tedavisi: Fonksiyonel Yöntem ve uzun dönemli izlem

Uluslararası literatürde çarpık ayakla ilgili önemli sayıda yayının varlığına rağmen, hastalığın halen çözülememiş yanları vardır. Günümüzde, konservatif tedavi yöntemleri cerrahiye göre daha avantajlı görünmektedir. Tedaviden sonra çarpık ayakla ilgili öngörüde bulunmak zordur; bu nedenle, uzun dönemli takibe gerek vardır. Biz, 30 yıldan fazla bir süredir, yalnızca nazik manipülasyonlara dayalı gerçek bir Fonksiyonel Yöntem uygulamaktayız. Bu tedavinin amacı deformiteyi düzeltmek ve çocuğun gecikmeksizin yürümesini sağlamaktır. Tedavinin prensibi ise, deformitenin sürekli düzeltilmesi girişimlerinden önce eklem kontraktürlerini gidermektir. Deformitenin ciddiyeti ve etyolojisi ile ilgili olarak herhangi bir ayrım yapılmamaktadır. Aile de rutin manipülasyonların evde yürütülmesi konusunda etkin bir rol oynamaktadır. Bu Fonksiyonel Yöntem üzerine, ekibimiz tarafından bugüne dek üç büyük çalışma yayımlanmıştır; bunlarda mükemmel-iyi sonuçların ağırlığı %77’yi bulmaktadır. Çarpık ayağın konservatif tedavisinde uyguladığımız Fonksiyonel Yöntem’in, deformitenin düzeltilmesi ve stabilizasyonunda uygun bir yol olduğuna inanıyoruz.

Anahtar Kelimeler:

Çarpık ayak, Çocuk, Manipülasyon, ortopedik

Conservative treatment of clubfoot: The Functional Method and its long-term follow-up

Despite the presence of a considerable number of papers published in the international literature, talipes equinovarus keeps its secrets. Conservative methods of treatment are currently accepted as advantageous over surgery. Prediction of the future of a clubfoot after treatment is not possible, for this reason, a long-term followup is needful. A true Functional Method based solely on gentle manipulations has been used for more than thirty years. Its aim is to correct the deformity and to allow the child to walk without delay. The principle of this method is to distract joint contractures prior to progressive correction of the deformity. No selection is made regarding the severity of the deformity and its etiology. Family plays an important role in performing routine manipulations at home. Concerning this Functional Method, three main series have been published by our team, with excellent- good results accounting for up to 77%. We believe that our Functional Method of conservative treatment of clubfoot is an appropriate way for correction of the deformity and its stabilization.

Keywords:

Clubfoot, Child, Manipulation, Orthopedic,

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