Ahmet Şükrü MERCAN, Güzelali ÖZDEMİR, Abdullah DENİRTAŞ, Kağan Arslan ARSLAN, İbrahim AZBOY, Sinan ZEHİR

Doğuştan çarpık ayaklı olgularda Ponseti yöntemi ile tedavi sonuçları

Amaç: Bu çalışmanın amacı Ponseti yöntemi ile tedavi ettiğimiz doğuştan çarpık ayaklı (DÇA) olguların sonuçlarını değerlendirmektir.Gereç ve yöntem: Çalışmaya doğuştan çarpık ayaklı 28 hastanın (18 erkek, 10 kız; ortalama yaş 2,2 ay; dağılım 6 gün-5 ay) 44 ayağı alındı. Tüm hastalarda Dimeglio Grade II, III, IV deformite vardı. Tüm hastalara Ponseti yöntemine göre elle düzeltme ve alçı uygulandı. Ekinizmin dirençli olduğu olgulara Aşil tenotomisi yapıldı. Elde edilen düzelmenin korunması için ayak abdüksiyon ortezi kullanıldı. Ortalama takip süresi 17 ay (dağılım 6-36 ay) idi.Bulgular: Yirmi altı hastanın 41 ayağı (% 93) Ponseti yöntemi ile başarıyla tedavi edildi. Otuz altı ayağa (% 81) perkütan aşilotomi uygulandı. Hiçbir ayağa posterior gevşetme uygulanmadı. Tüm ayaklarda başlangıçta düzelme sağlanmasına rağmen, 14 hastada (% 31) nüks görüldü. Nükslerin ortez kullanmaya uyumsuzluktan kaynaklandığı tespit edildi.Sonuç: Ponseti yöntemi, idiyopatik tip DÇA deformitesinde etkili ve güvenilir bir yöntemdir. Nükslerin önlenmesinde, ayak abdüksiyon ortezine uyumu artırmak için aileyi eğitmenin ve ayakkabıyı yapan ortotistin deneyimli olmasının önemli olduğu gösterildi

Outcomes of the congenital clubfoot deformity treated by Ponseti’s method

Objectives: The purpose of this study was to evaluate our result in patients with congenital clubfoot deformity who had been treated with Ponseti’s technique.Materials and methods: The study included 28 patients (18 males, 10 females, mean age 2.2 months; range 6 days to 5 months). All patients had Dimeglio grade II, III, and IV deformities. All patients had manipulation and casting according to the Ponseti’s technique. Achilles tenotomy was performed in the persistent equines. Maintenance of correction was obtained with the use of foot abduction orthosis. Mean follow-up period was 17 months (range 6-36 months).Results: Forty-one feet of 28 patients were treated according to the Ponseti’s technique. Achilles tenotomy was performed in 31 feet (81%). Posterior release was not performed in any patient. Although, correction was maintained in all feet at the beginning, 14 feet (31%) were relapsed. The relapses were due to decreased compliance to foot abduction orthoses.Conclusion: Ponseti technique is an effective, and reliable in correction of idiopatic congenital clubfoot deformity. The results also suggest that the role of family education to enhance compliance to brace application and experienced orthotist are important to prevent relapses.

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