Clubfoot: The Treatment Outcome Using Quantitative Assessment of Deformity.
The recent trend in management of congenital idiopathic clubfoot tends towards conservative treatment. This study reviews the outcomes of treatment in our practice using the quantitative clubfoot assessment of the deformity (QCAD). Methods: Thirty patients (38 cases of clubfoot) with congenital idio...
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| Main Authors: | , , , |
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| Format: | E-Article |
| Language: | English |
| Published: |
Malaysian Orthopaedic Association
2012
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| Subjects: | |
| Online Access: | http://ir.unimas.my/id/eprint/7453/1/clubfoot-the-treatment-outcome.pdf http://ir.unimas.my/id/eprint/7453/ http://www.morthoj.org/2012/v6n3/clubfoot-the-treatment-outcome.pdf |
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| Summary: | The recent trend in management of congenital idiopathic clubfoot tends towards conservative treatment. This study reviews the outcomes of treatment in our practice using the quantitative clubfoot assessment of the deformity (QCAD). Methods: Thirty patients (38 cases of clubfoot) with congenital idiopathic clubfoot treated at Sarawak General Hospital were followed-up for a mean of 3.6 years. The quantitative assessment consists of limb anthropometric measurement and the Pirani deformity severity score.
Results: There were 15 boys and 15 girls, with a mean age
of 4.4 years (range, 13m - 8y). Most patients were of the
Malay race (67%), followed by Chinese (23%) and others
(10%). Eight patients suffered from bilateral congenital
idiopathic clubfoot (33%), 12 were left unilateral (40%) and
10 were right unilateral (27%). Out of the total of 30 patients, 12 were treated conservatively with serial casting and 18 patients were treated surgically after resistance to serial casting at the age of nine months. At follow-up, there were significant differences between the surgical group (2.57 ±
1.45); (0.86 ± 0.36) and conservative group (0.7 ± 0.81);
(0.34 ± 0.35) respectively (p < 0.05) regarding the mean
difference in mid-leg circumference and foot length
discrepancy in patients with unilateral clubfoot. There were
no significant difference noted between groups with regards
to results of the Pirani score, leg length discrepancy and
mean difference of mid-foot circumference.
Conclusion:
There were significant differences in calf atrophy and foot
length discrepancy when comparing surgically treated clubfoot patient compared to conservatively treated patients. Conservative treatment of clubfoot is the preferred method
of treatment while surgical treatment may be necessary in
more resistant cases. |
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