Tibiotalar Incongruency in Clubfoot Treated Operatively Is a Predictor of Worse Outcome at a Mean of 26 Years

التفاصيل البيبلوغرافية
العنوان: Tibiotalar Incongruency in Clubfoot Treated Operatively Is a Predictor of Worse Outcome at a Mean of 26 Years
المؤلفون: Paolino Iorio, Francesco Sadile, Francois Lintz, Alessio Bernasconi, Robbie Ray
المساهمون: Bernasconi, Alessio, Iorio, Paolino, Lintz, Françoi, Ray, Robbie, Sadile, Francesco
المصدر: The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons. 60(4)
سنة النشر: 2019
مصطلحات موضوعية: operative, medicine.medical_specialty, Prognostic factor, Clubfoot, Radiography, Visual scale, 03 medical and health sciences, 0302 clinical medicine, Recurrence, ankle, medicine, Humans, Orthopedics and Sports Medicine, In patient, Congenital talipes equinovarus, Patient Reported Outcome Measures, Physical Examination, 030222 orthopedics, business.industry, Intraobserver reliability, Reproducibility of Results, talus, medicine.disease, Surgery, medicine.anatomical_structure, talipes equinu, long term, Ankle, business, 030217 neurology & neurosurgery
الوصف: The traditional approach to congenital talipes equinovarus (CTEV) has relied on stepwise manipulations, followed by surgery in severe or recurrent cases. The 3 aims of this study were: (1) to report long-term results of clubfoot treated by posterior capsulectomy and selective release (PCSR); (2) to determine the reliability of a visual scale in the assessment of intraoperative tibiotalar incongruency (TTI); and, (3) to assess the role of TTI as a prognostic factor. We reviewed data regarding 95 CTEV (65 patients) treated by PCSR at a minimum follow-up of 20 years. Patients underwent a physical and radiographic examination, and were assessed through multiple clinical scores. The inter- and intraobserver reliability for TTI evaluation was calculated on clinical photographs. Based on TTI, 52 CTEV were divided in 2 groups (30 congruent vs 22 incongruent) and compared. At a mean follow-up of 26.8 (from 24 to 31) years, 52 CTEV (38 patients) were available for the analysis. Functional results were globally satisfactory. The inter- (κ = 0.748) and intraobserver analysis (κ = 0.688) for the TTI visual assessment showed substantial agreement. In patients with incongruency, patient reported outcomes were significantly worse, with also a greater development of subtalar (p = .02), talonavicular and calcaneocuboid arthritis (p < .001 for both). In treating severe CTEV, the surgical PCSR performed in the first year of life obtains satisfactory clinical and patient-recorded outcomes at over 25 years of follow-up. The visual assessment of TTI is reproducible and potentially represents a long-term prognostic factor.
تدمد: 1542-2224
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::607d8745b6884b57bdee0f852e8d01ab
https://pubmed.ncbi.nlm.nih.gov/33744065
حقوق: CLOSED
رقم الأكسشن: edsair.doi.dedup.....607d8745b6884b57bdee0f852e8d01ab
قاعدة البيانات: OpenAIRE