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[Treatment results of Imhäuser's method of treating neonatal clubfeet]
T Kausch1, J Rütt, M H Hackenbroch
1Klinik und Poliklinik für Orthopädie, Universität zu Köln.
Insights
This study on treating newborn clubfoot found that while 83.7% of cases had good clinical results, only 43.6% were good radiologically. Parental cooperation is crucial for successful clubfoot treatment outcomes.
Area of Science:
- Orthopedics
- Pediatric Surgery
- Rehabilitation Medicine
Context:
- Clubfoot (congenital talipes equinovarus) is a common birth defect requiring early intervention.
- Treatment protocols have evolved, emphasizing long-term follow-up and multidisciplinary approaches.
- Assessing treatment efficacy requires both clinical and radiological evaluation methods.
Purpose:
- To report long-term clinical and radiological outcomes of a specific clubfoot treatment protocol.
- To analyze the correlation between clinical and radiological findings.
- To determine the significance of parental cooperation in clubfoot management.
Summary:
- A cohort of 88 children with 123 clubfeet underwent surgical correction (achillotenotomy, capsulolysis) in infancy, followed by intensive physiotherapy, orthotics, and monitoring.
- Clinical assessment at 6 years 3 months showed good or acceptable results in 83.7% of cases.
- Radiological assessment yielded good or acceptable results in only 43.6%, with no clear correlation between clinical and radiological outcomes. Ankle joint mobility, particularly in flat-top-talus cases, impacted functional results.
Impact:
- Highlights potential discrepancies between clinical appearance and underlying radiological changes in treated clubfoot.
- Emphasizes the critical role of consistent parental involvement in achieving optimal functional outcomes.
- Suggests a need for refined radiological assessment criteria or further investigation into long-term radiological progression.
Abstract:
The results of treatment of newborn clubfoot are reported 6 years and 3 months after operation. 88 children with 123 clubfeet were treated beginning at the neonatal period with redressment and casting followed by achillotenotomy and dorsomedial and dorsolateral capsulolysis of the talocrural and talocalcaneal joints at 4 to 7 months of age. After that a strict protocol of physiotherapy, orthetics and controlling was used. For clinical and radiological assessment the criteriasof Magone (40) and Simons (51, 52) were used. The significance of parental cooperation was analysed. At follow-up the result was good or acceptable in 83.7% according to clinical findings and 43.6% according radiology respectively. There was obviously no correlation of clinical and radiological findings. The mobility of the ankle joint proved to be important regarding the functional result, especially in cases with flat-top-talus it has been limited. Parenteral cooperation is of special importance for good results in clubfoot-therapy.