PDF(Pubmed)
Abstract：
BACKGROUND: Congenital talipes equinovarus (CTEV) is one of the common congenital disorders in pediatric orthopedic practice that affects a large group of children.It is a combination of four parts of deformity that affect either a single foot or both feet. Our aim in this study is to estimate the prevalence and incidence of CTEV and to evaluate the risk factors that lead to relapse in some children to avoid relapse in future and complex surgical interventions, as well as to improve the final outcome.
METHODS: A retrospective cohort study for the cases of CTEV was conducted to estimate the prevalence of relapse in children with CTEV after management by the Ponseti method and to evaluate the risk factors that lead to recurrence.
RESULTS: The study includes 103 patients with CTEV, and only 22 patients had relapse. The prevalence rate of relapsed cases was 20.4%, and the incidence was 42 per thousand. The average number of casts applied was 4.05 ± 1.37. The average severity of the deformity that was measured by the Pirani score was 4.97 ± 1.21. The most common atypical presentation of CTEV was associated with developmental dysplasia of the hip (DDH), followed by myelomeningocele (MMC).
CONCLUSIONS: The only significant factors in the study were the Pirani score and non-compliance of the brace with p < 0.05. There was not any significance in the correction of the deformity by Ponseti between idiopathic and non-idiopathic CTEV based on the number of casts and the Pirani score. The dynamic foot brace can be the solution for the high recurrence rate, yet more studies are needed in the future.
METHODS: A retrospective cohort study for the cases of CTEV was conducted to estimate the prevalence of relapse in children with CTEV after management by the Ponseti method and to evaluate the risk factors that lead to recurrence.
RESULTS: The study includes 103 patients with CTEV, and only 22 patients had relapse. The prevalence rate of relapsed cases was 20.4%, and the incidence was 42 per thousand. The average number of casts applied was 4.05 ± 1.37. The average severity of the deformity that was measured by the Pirani score was 4.97 ± 1.21. The most common atypical presentation of CTEV was associated with developmental dysplasia of the hip (DDH), followed by myelomeningocele (MMC).
CONCLUSIONS: The only significant factors in the study were the Pirani score and non-compliance of the brace with p < 0.05. There was not any significance in the correction of the deformity by Ponseti between idiopathic and non-idiopathic CTEV based on the number of casts and the Pirani score. The dynamic foot brace can be the solution for the high recurrence rate, yet more studies are needed in the future.
摘要：
背景：先天性马蹄内翻足（CTEV）是儿科骨科中常见的先天性疾病之一，影响了一大批儿童。它是影响单脚或双脚的畸形的四个部分的组合。我们在这项研究中的目的是估计CTEV的患病率和发病率，并评估导致某些儿童复发的危险因素，以避免在未来和复杂的手术干预中复发。以及改善最终结果。
方法：对CTEV病例进行回顾性队列研究，以评估Ponseti方法治疗后儿童CTEV的复发率，并评估导致复发的危险因素。
结果：该研究包括103例CTEV患者，只有22名患者复发。复发病例的患病率为20.4%,发病率为42‰。应用的平均模型数为4.05±1.37。通过Pirani评分测量的畸形的平均严重程度为4.97±1.21。最常见的CTEV非典型表现与髋关节发育不良（DDH）有关，其次是脊髓膜膨出（MMC）。
结论：研究中唯一有意义的因素是Pirani评分和支具的不顺应性，p<0.05。根据石膏数量和皮拉尼评分，在特发性和非特发性CTEV之间，Ponseti矫正畸形没有任何意义。动态足支具可以解决高复发率，然而，未来还需要更多的研究。
方法：对CTEV病例进行回顾性队列研究，以评估Ponseti方法治疗后儿童CTEV的复发率，并评估导致复发的危险因素。
结果：该研究包括103例CTEV患者，只有22名患者复发。复发病例的患病率为20.4%,发病率为42‰。应用的平均模型数为4.05±1.37。通过Pirani评分测量的畸形的平均严重程度为4.97±1.21。最常见的CTEV非典型表现与髋关节发育不良（DDH）有关，其次是脊髓膜膨出（MMC）。
结论：研究中唯一有意义的因素是Pirani评分和支具的不顺应性，p<0.05。根据石膏数量和皮拉尼评分，在特发性和非特发性CTEV之间，Ponseti矫正畸形没有任何意义。动态足支具可以解决高复发率，然而，未来还需要更多的研究。
