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Complex iatrogenic clubfoot: is it a real entity?
Massimiliano Dragoni1, Armando Gabrielli, Pasquale Farsetti
1Department of Orthopaedic Surgery, University of Rome 'TOR VERGATA', Viale Oxford, Rome, Italy.
Journal of Pediatric Orthopedics. Part B
|March 27, 2018
Summary
Complex iatrogenic clubfoot can develop from improper treatment. Early intervention with the modified Ponseti protocol shows mixed results, with a high relapse rate in these challenging cases.
Area of Science:
- Orthopedics
- Pediatric Orthopedics
- Surgical Innovation
Background:
- Clubfoot is a common congenital foot deformity.
- Iatrogenic injuries can arise from medical interventions.
- The existence and characteristics of complex iatrogenic clubfoot require further elucidation.
Purpose of the Study:
- To confirm the existence of complex iatrogenic clubfoot.
- To identify the mechanisms causing this condition.
- To evaluate treatment outcomes using the modified Ponseti protocol.
Main Methods:
- Observation of 54 previously treated clubfeet.
- Classification of feet based on deformity characteristics.
- Treatment of complex iatrogenic clubfoot with the modified Ponseti protocol.
- Follow-up evaluation using the International Clubfoot Study Group Score.
Main Results:
- Nine cases presented as complex iatrogenic clubfoot.
- Average follow-up was 7.2 years.
- Treatment yielded 2 excellent, 5 good, and 2 fair results.
- A 55% relapse rate was observed in complex clubfeet.
- Relapsed cases required Achilles tenotomy or tendon transfer.
Conclusions:
- Faulty manipulation and casting can create complex iatrogenic clubfoot.
- Severe clubfoot, foot morphology, and cast issues are risk factors.
- Proper treatment can yield positive outcomes, but relapse is a concern.
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