What should we do for patients who are not feasible for using Dennis-Brown bar, after correction with the Ponseti Method?
Authors: Aysegul BURSALI, Timur YILDIRIM, Sukru Sarper GURSU, Bahattin Kerem AYDIN
Institution: Metin Sabanci Baltalimani Bone Diseases Training Hospital, Orthopedics and Traumatology Clinic, Istanbul, TURKEY
This paper is a revised and updated version of the presentation made at the EPOS 2007 meeting in Italy.
It’s now well known that bracing after correction of clubfoot deformity is a necessity for a successful end result. Though it’s the most commonly used device for this purpose Dennis-Brown bar is sometimes not a suitable choice. In this paper we evaluated the success of an abduction orthosis, we use for patients with clubfoot deformity after correction with the Ponseti method.
Between 1999 and 2007; 299 patients with clubfoot deformity
these patients had bilateral clubfeet and 12 had unilateral (34 clubfeet). 9 patients had previous history of treatments other then the Ponseti method. The number of the casts used for the correction of the deformity was in average 5.7 (4-8). 12 of the patients underwent percutaneus achilles tenotomy under local anesthesia.
The initial indication to use this orthosis is metatarsus adductus. It consists of 2 pieces and a calcaneal support which is our modification. The device was applied to 23 patients. 16 patients were given this device because of their intolerance to the Dennis-Brown bar. 2 had very fat feet so they were given this device as they couldn’t wear shoes.1 of them was very small (11 days old at presentation) and fitting shoes could not be made for his feet. The last child to use this device had a rudimentary left leg and a right clubfoot. Non-compliance with this device was not observed for any of these patients.The device did not lead to any complications but recurrence was observed in one of the cases.
There’s a consensus on the fact that bracing after correction of clubfoot with the Ponseti method is a necessity. We believe that in cases where Dennis-Brown bar is not feasible the
device, we use, could be a successful alternative.
Corresponding Author : Dr. Aysegul BURSALI