European Journal of Molecular & Clinical Medicine

Background:
A prospective study to determine effectiveness of Ponseti method in correcting clubfoot in children aged 2-10 years and failed or recurrent clubfoot in older aged children was done at Department of Orthopaedics&Traumatology.
Two patients had pressure ulcer on talar headOne patient had allergy to plaster material.The plaster breakage was common complication in the older children.
The correction rate with ponseti method is over 90% can accomplished in about two to three months without extensive surgery. It has also been demonstrated that the ponseti method can be successful in clubfeet that recurs after extensive surgery.

Background: Idiopathic clubfoot is characterized by an alteration of the morphology of the foot
that cannot physiologically move on the ground. Tibialis anterior tendon transfer was is an
effective method in the management of dynamic supination as well as prevention of clubfoot
relapse in children. The aim of the current study to confirm the best management of split tibialis
anterior tendon transfer in the treatment of residual clubfoot. Patients and methods: A
prospective study included 18 patients (22 feet) with residual dynamic supination deformity
following previous ponseti management. Patients underwent split transfer of the anterior tibial
tendon at Zagazig University hospitals. Clinical and radiographic assessment of outcomes is
performed at the end of healing. Results: The present study included 18 cases (12 males and 6
females) with mean age of 3.43 years ± 0.71 to assess outcome of split tibialis anterior tendon
transfer in management of residual clubfoot. Patient age ranged from 2.5 years to 5 years old at
the time of the operation, 9 with right foot affection, 5 with left foot deformity while 4 patients (8
feet) were bilateral. The majority of cases were males (66.7%) and females were (33.3%).Right
side was affected in 9 cases (50%), the left was affected in five .cases (27.8%) while four cases
(22.2%) were bilateral. The mean radiological measurment improvement of AP talocalcaneal
angle, AP talofirst metatarsal angle, Lattalocalcanael angle, Lattalo-first metatarsal angle, Firstfifth
metatarsal over lap, and the improvement of all angles were stastistically significant. The
complication rate was 16.7% (3 cases) all had superfecial infection only. Conclusion: The
anterior tibial tendon transfer is a practical method for achieving fully or split transfer due to
both techniques have an excellent outcomes with low complication. It is simple and effective softtissue
procedure to correct the muscle imbalance of the foot. The split tibialis tendon transfer are
still better because of low risk of over correction which preserve some inversion function.

Abstract: Despite modern advances in paediatric traumatology and orthopaedics in the
treatment of patients with foot deformities, conservative and surgical strategies of cure are
nevertheless considered unsuccessful, to a giant extent if the problem is a recurrent or
justified congenital ailment of the central or peripheral apprehensive system. For the therapy
of children with congenital clubfoot we have used a huge range of treatments, including
purposeful techniques (corrective massage, TPT, carrying functional tires), fixation methods
(bandaging, staged plaster bandages), physiotherapy (electrostimulation, hydrotherapy, UHF,
ultrasound, electrophoresis, etc.). Specialized remedy included: orthopaedic (wearing
orthopaedic footwear with inlays, shafts, bandages made of thermoplastic), conservative and
surgical treatment. Analysis of the bought remedy effects in distinct age groups showed that
the major undertaking of treatment and its success depends on early restoration of anatomical
relations in the joint. Thus, in teenagers under one-year-old, appropriate diagnostics and
software of atraumatic functional methods of remedy primarily based on Ponset approach
allowed achieving good results with a significant discount in the number of plaster bandages
and accordingly decreasing the cure duration in universal to 2 months. The find out about of
the experience of cure of congenital clubfoot based totally on its cloth showed that the use of a
unique cure approach relies upon on the assessment of the severity of foot deformation. The
chosen treatment systems need to be intensive and consistent, beginning from the early
duration after birth, when the foot deformity is cellular and bendy to correction. The new
technique of surgical treatment, change of achillotomyms in accordance to the Ponset method,
allowed us to get suitable beauty result barring lowering the effectivity of the surgical
intervention. Another benefit of this technique reduces the length of the operation and reduces
soft tissue trauma in the Achilles tendon area.