Clubfoot and Vertical Talus : Etiology and Clinical Management

Preface
Preface
Contents
Chapter 1: Etiology and Pathogenesis of Clubfoot and Vertical Talus
Environmental Factors
Mechanistic Studies of Isolated Clubfoot
Familial Inheritance of Clubfoot
Syndromic Versus Isolated Clubfoot
Expansion of Syndromic Phenotypes to Include Isolated Clubfoot
PITX1
Chromosome 17q23.1q23.2 Microdeletions and Microduplications
HOXC Microdeletions and Missense Mutations in Clubfoot
Common Genetic Variants in Clubfoot
PITX1-TBX4-HOXC Mutations and Treatment Resistance
Vertical Talus
Implication of Transcriptional Regulators of Early Limb Development in Vertical Talus
Conclusions
References
Chapter 2: Classification of Clubfoot
Introduction
Clinical Evaluation
Postural Clubfoot
Congenital Clubfoot
Clubfoot Assessment
Clubfoot Classification
Ponseti and Smoley Classification System (1963)
Manes, Costa, and Innao Classification System (1975)
Harrold and Walker Classification System (1983)
Catterall Rading System (1991)
Goldner and Fitch System (1994)
Dimeglio’s et al. grading System (1995)
Pirani’s Score (1995)
Clubfoot Evaluation During Growth
Carroll’s System for Evaluating Clubfoot Results
Conclusion
References
Chapter 3: From the Ponseti Method to the French Method: Research of a Consensus
Introduction
Can We Reconcile the French Functional Physical Therapy Method and the Ponseti Method?
Can the “Hybrid Method” Improve the Outcome of Conservative Treatment?
Surgery “à La Carte”
Conclusions
References
Chapter 4: Treatment of Clubfoot After Walking Age
Delayed Treatment
Children Undergoing the Ponseti Method
Scoring Systems for the Older Child with Clubfoot
Treatment Challenges
Ponseti Method Pearls
Documentation Is Essential
Complications with Extended Casting
Bracing Protocol
Achilles Tendon Tenotomy
Anterior Tibial Tendon Transfer
Psychological Aspects
Surgical Correction
Future Directions
References
Chapter 5: Management of Atypical Clubfoot: Challenges and Solutions
Introduction
Atypical Clubfoot
Treatment of Atypical Clubfoot
Modified Ponseti Technique
Dobb’s Adaptation Technique
Imaging
Consultations
Bracing Protocol
Relapse
Conclusion
References
Chapter 6: Management of Complex Clubfoot: Challenges and Solutions
Introduction
Complex Clubfoot
Modified Ponseti Technique
Dobb’s Adaptation Technique
Imaging
Consultations
Bracing Protocol
Relapse
References
Chapter 7: Surgical Release for Clubfoot: Principles, Indications, and Evaluation
Introduction of Comprehensive Surgical Releases
Surgical Principles and Technique
Surgical Technique
Pitfalls and Complications
Introduction of the Clinical Evaluation of Clubfoot Treatment Outcome
Physical Examination
Radiographic Assessment
Strength Evaluation
Gait Analysis
Pedobarography
Quality of Life Outcomes Self-Assessment
Future Assessment Tools
Recent Publications on Evaluation of Clubfoot Treatment Outcome Research
Conclusion
References
Chapter 8: Managing Clubfoot Relapses Following Ponseti Method Treatment: Approach Based on Age and Residual Deformity
Introduction
Recognition of Relapses
Principles of Relapse Correction
Specific Relapse Patient Scenarios
Recurrent Deformity with Difficulty in Bracewear During the First 6 Months Following Initial Cast Correction (Inadequate Initial Correction Vs. Early Relapse)
Relapses Before Age 2 1/2 Years
Early Relapses in Patients Who Are Noncompliant with Bracing
Dynamic Supination Relapses After Age 2 1/2 Years
Equinus Relapses/Inadequate Ankle Dorsiflexion
Relapse Following Prior Tibialis Anterior Tendon Transfer
Late Relapse After Age 4 Years
Adduction/Varus Relapse in Older Child with Deformities that Do Not Respond to Serial Manipulation and Casting
Persistent in Toeing Gait Following Congenital Club Treatment
Conclusion
References
Chapter 9: Extensive Soft Tissue Release for Congenital Vertical Talus
Evolution of Surgery in Congenital Vertical Talus
Surgical Pathology [1, 19, 20]
Bone Changes
Calcaneum
Talus
Navicular
Cuboid
Ligament Changes
Muscle Changes
Joint Changes
Radiologic Assessment
Indications for Open Surgery
Aim of Treatment
Incisions
Authors’ Preferred Technique
Case Example
Assessment of Results
Complications
Immediate
Early
Late
Minimal Invasive Surgery Versus Extensive Release
References
Chapter 10: Congenital Vertical Talus (Congenital Convex Pes Valgus)
Introduction
Etiology
Pathoanatomy: Congenital Vertical Talus Deformity
Clinical Features
Imaging
Classification
The Dobbs Method
Calcaneovalgus
Oblique Talus
References
Index