Hasan Ulaş OĞUR, Fırat SEYFETTİNOĞLU, Ümit TUHANİOĞLU, Alper GÜLTEKİN, Şükrü SOLAK

Treatment Results of the Ponseti Method in Patients with Idiopathic Pes Equinovarus

INTRODUCTION: Congenital clubfoot (pes equinovarus) treatment is currently applied with serial manipulation and plaster casting with the modern treatment method described by Ponseti. In orthopaedics, the plaster cast material used is usually the classic white plaster (plaster of Paris; POP) and more rarely semi-rigid, fibreglass (SRF). The aim of this study was to evaluate the efficacy of these two materials in the Ponseti method and to identify the advantages of each. METHODS: A total of 27 feet of 16 patients (12 male, 4 female) treated between 2006 and 2008 were included for evaluation. The patients were separated into 2 groups, as Group 1 with 16 feet of 9 patients applied with POP, and Group 2 with 11 feet of 7 patients applied with SRF. The efficacy of the two methods was evaluated in respect of the properties of the cast materials and complications. The Pirani and Dimeglio scores were examined. RESULTS: The mean Dimeglio score was 12.81 before treatment and 2.56 after treatment. The mean Pirani score was 4.125 before treatment and 0.531 after treatment. The mean follow-up period was 18 months. A statistically significant improvement in clinical scores was observed in both groups (p0.05). It was determined that less skin pressure injury could be seen with fibreglass synthetic plaster cast.

İdiopatik Pes Ekinovaruslu Hastalarda Ponseti Yöntemiyle Tedavi Sonuçlarımız

GİRİŞ ve AMAÇ: Congenital clubfoot(pesekinovarus) tedavisi, günümüzde modern tedavi yöntemi Ponseti tarafından tanımlanan yöntemle, seri manipulasyon ve alçılama ile yapılmaktadır. Ortopedi de alçılama materyali olarak sıklıkla klasik beyaz alcı (plaster of paris=POP) ve daha nadiren fiberglass (SRF) alçı kullanılmakatdır. Çalışmanın amacı ponseti yönteminin ve bu 2 materyalin etkinliğini değerlendirmek ve birbirlerine üstünlüklerini belirlemektir. YÖNTEM ve GEREÇLER: 2006-2008 yılları arasında 16 hastanın 27 ayağı değerlendirilmeye alındı(12 erkek 4 kız) hastalar 2 gruba ayrıldı. 1. gruptaki 9 hastanın 16 ayağına klasik beyaz alçı(Plaster of Paris) 2. gruptaki 7 hastanın 11 ayağına sentetik soft cast alçı(SRF) uygulandı. Yöntemin etkinliği alçı materyallerinin özelliği ve komplikasyonlar değerlendirildi. Pirani ve Dimeglio skorlarına bakıldı. BULGULAR: Tedavi öncesi 12.81 olan ortalama Dimeglio skoru tedavi sonrası 2.56 olarak tespit edildi. Pirani skoru tedavi öncesi 4.125 iken tedavi sonrası ortalama değer 0.531 bulundu. Ortalama takip süresi 18 ay. Her 2 grupta klinik skorlarda istatistiksel olarak anlamlı düzelme tespit edildi(p0.05). Fiberglass sentetik alçı ile daha az basınca bağlı cilt yaralanması görülebileceği tespit edilmiştir..

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