OBJECTIVE: The aim of this study was to assess the role of sonographic evaluation of Talar dysplasia in predicting the outcome of standard Ponseti method in the treatment of clubfoot deformity. METHODS: A total 23 children (15 boys and 8 girls; mean age: 18.2 ± 5.4 days (8-32)) who underwent Ponseti treatment were included in the study. Before the treatment, maximal talus length of affected and non-affected feet were measured by US and relative talar dysplasia ratio (RTDR) was calculated. The patients were categorized 2 groups according to RTDR: group A - mild and group B - severe deformity. Pirani score was used for clinical evaluation. The groups were compared in terms of number of the applied casts, need of percutaneous tenotomy of Achilles tendon (AchT) and frequency of deformity recurrence. RESULTS: Pirani score was 4.46 for population (4.33 for group A; 4.54 for group B). Number of casts significantly differed between groups (p < 0.001) and positive correlation was found (r = 0.851, p < 0.001). AchT was performed in 56% cases for group A and in 86% cases for group B; no statistically significant difference was obtained (p = 0.162). Recurrence occurred in 2 patients belonging to group B without significant difference compared to group A (p = 0.502). CONCLUSION: Talar dysplasia assessment appeared as a promising prognostic factor for predicting the outcome of the Ponseti technique in treatment of clubfoot deformity. LEVEL OF EVIDENCE: Level IV, diagnostic study.
- MeSH
- Achillova šlacha chirurgie MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- pes equinovarus * diagnóza patologie patofyziologie chirurgie MeSH
- prediktivní hodnota testů MeSH
- prognóza MeSH
- recidiva MeSH
- sádrové obvazy MeSH
- talus * abnormality diagnostické zobrazování MeSH
- tenotomie * metody statistika a číselné údaje MeSH
- ultrasonografie metody MeSH
- Check Tag
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika MeSH
UNLABELLED: Talus bipartitus is a rare skeletal variation. Several causative factors have been proposed, but none of them seem to be convincing. We hypothesize that talus bipartitus may result from ossification disruption in neonatal period caused possibly by an infection. The observations supporting this link are discussed. The hypothesis is supported by two cases with symptomatic talus bipartitus illustrating the postulated connection. KEY WORDS: ankle, pain etiology, talus abnormalities, talus bipartitus.
- MeSH
- bolest etiologie MeSH
- dospělí MeSH
- hlezenní kloub diagnostické zobrazování embryologie mikrobiologie MeSH
- lidé MeSH
- talus abnormality diagnostické zobrazování chirurgie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
An ankle bone consisting of several fragments is a rare anatomical variant of the talus, in the literature described as talus partitus or frontal split. On radiographs or CT scans it presents as two or more relatively large fragments. The term talus partitus is sometimes incorrectly used for an accessory bone that occasionally develops behind the ankle bone and is called os trigonum. talus partitus is an unusual developmental anomaly in which the talus is partitioned although it ossifies from a single centre. The cause of its split has not been explained although this may also be due to a previous unrecognized injury. In the Slovak medical literature no report of this anomaly has been found. Here we resent the case of a 30-year-old man in whom the ankle bone split was an incidental finding. This patient also had ipsilateral developmental dysplasia of the hip. This is the first report of a patient with the two concurrently found anomalies.
- MeSH
- dospělí MeSH
- lidé MeSH
- talus abnormality MeSH
- vrozené deformity nohy (od hlezna dolů) MeSH
- vývojová kyčelní dysplazie radiografie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
Vrozeně strmý talus je poměrně vzácná vrozená strukturální vada nohy, která se asi v polovině případů vyskytuje samostatně, v polovině případů ve spojení s jinými vadami. Ačkoliv je pohled na léčbu této vady ne vždy jednoznačný, je jasné, že pouze chirurgické léčení může vést k repozici talonavikulárního kloubu a uvolnění kontraktur na dorzolaterální straně nohy. Podle literárních pramenů se doporučuje provést výkon ideálně mezi 10 až 12 měsícem věku dítěte. Dnes spíše než dříve doporučovaný dvojdobý výkon Herndonův-Heymanův je preferován jednodobý výkon podle Crawforda. Soubor a metody: Pro léčbu našich pacientů používáme jednodobý výkon vycházející z principů Crawfordových, doplněný u některých starších dětí přídatnými výkony (osteotomie tarzu, subtalární déza, svalové transfery). Výsledky a závěr: Naše výborné a dobré výsledky (89,5 % resp. 88,8 %), kterých jsme dosáhli u souboru našich pacientů ukazují na vhodnost použití tohoto postupu a to i u dětí starších.
The vertical talus is a rare congenital deformity of the foot. It is an isolated idiopathic deformity in about half of all cases. In the others, it is associated with abnormalities such as arthrogryposis, myelodysplasia, DDH. Material and Methods: The surgical correction may be carried out at 10 to 12 months of age by literature, but our cohort of patients involved older children too. We use one stage procedure sec Crawford with some additional procedures such as opening dorsal osteotomy, subtalar Grice procedure and muscle transfers. Results and Conclusion: Our procedures show excellent and good results (89.5% resp. 88.8%) in the treatment of this congenital deformity of the foot. We recommend this one stage procedure in the treatment of older patients too.
OBJECTIVE: Congenital vertical talus is a rare condition but a well-known cause of severe rigid flatfoot in children. The aim of this study was to evaluate the mid-term clinical and radiological results of one-stage surgical correction in children with congenital vertical talus. METHODS: Five feet in three children diagnosed with congenital vertical talus who had undergone surgical correction were followed up for a mean period of seven and half years. During this period they were clinically evaluated for subjective complaints and objective findings focused on the range of movement at the ankle joint, position of the hindfoot, and weight-bearing ability of the treated extremity. They were also evaluated on the basis of radiographs of foot and ankle made in standard projections. RESULTS: All the children had a good functional range of movement and normally shaped foot. The range of movement remains restricted and decreased during the follow-up period without causing any functional disability. All radiological measurements were within normal limits. There was no evidence of necrosis of talus. CONCLUSION: We recommend operative treatment for congenital vertical talus by the end of first year of age. The range of movement remains restricted and seems to decrease during follow-up, which had a little effect on the functional outcome of the ankle joint (Fig. 3, Tab. 1, Ref. 18). Full Text (Free, PDF) www.bmj.sk.
- MeSH
- dítě MeSH
- lidé MeSH
- ortopedické výkony metody statistika a číselné údaje MeSH
- talus abnormality chirurgie MeSH
- vrozené deformity nohy (od hlezna dolů) diagnóza chirurgie terapie MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- Publikační typ
- srovnávací studie MeSH
