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The classic: observations on pathogenesis and treatment of congenital clubfoot. 1972.

Ponseti IV, Campos J - Clin. Orthop. Relat. Res. (2009)

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ABSTRACT

This Classic article is a reprint of the original work by Ignacio V. Ponseti and Jeronimo Campos, Observations on Pathogenesis and Treatment of Congenital Clubfoot. An accompanying biographical sketch on Ignacio V. Ponseti, MD, is available at DOI 10.1007/s11999-009-0719-8 and a second Classic article is available at 10.1007/s11999-009-0720-2. This article is ©1972 by Lippincott Williams and Wilkins and is reprinted with permission from Ponseti IV, Campos J. Observations on Pathogenesis and Treatment of Congenital Clubfoot. Clin Orthop Relat Res. 1972;84:50–60.

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(A, top), Boy with right clubfoot treated in infancy by plaster cast applications and tendo-Achillis lengthening in another hospital and first seen by us at 5 years of age. Following manipulation and 3 plaster cast applications, the heel-cord was lengthened again and the anterior tibialis was transferred to the cuboid and the extensor hallucis longus was recessed to the neck of the first metatarsal. (B, bottom), At 19 years of age the right foot is well aligned with normal range of motion in all its joints except for limited ankle dorsiflexion to 10 degrees. The strength of the transferred anterior tibial is 5 +. The circumference of the right calf measures 2 inches less than the left. (C) Standing anteroposterior and lateral roentgenograms show mild supination in both feet. The right navicular is slightly wedge shaped.
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Fig6: (A, top), Boy with right clubfoot treated in infancy by plaster cast applications and tendo-Achillis lengthening in another hospital and first seen by us at 5 years of age. Following manipulation and 3 plaster cast applications, the heel-cord was lengthened again and the anterior tibialis was transferred to the cuboid and the extensor hallucis longus was recessed to the neck of the first metatarsal. (B, bottom), At 19 years of age the right foot is well aligned with normal range of motion in all its joints except for limited ankle dorsiflexion to 10 degrees. The strength of the transferred anterior tibial is 5 +. The circumference of the right calf measures 2 inches less than the left. (C) Standing anteroposterior and lateral roentgenograms show mild supination in both feet. The right navicular is slightly wedge shaped.

Mentions: Roentgenograms of these feet rarely show a completely normal foot. Some flattening of the superior articular surface of the talus was observed in 18 cases, and in nearly all there was mild dorso-lateral wedging of the navicular. The navicular was normally aligned with the head of the talus in 33 feet; it was displaced slightly medially in 18 feet and laterally in 7. The talocalcaneal index (the sum of the talocalcaneal angles in the AP and lateral roentgenograms [2]) was within normal limits, from 40 to 85°, in 46 feet and was less than 40° in 12 feet (Figs. 5 and 6).Fig. 5A–B


The classic: observations on pathogenesis and treatment of congenital clubfoot. 1972.

Ponseti IV, Campos J - Clin. Orthop. Relat. Res. (2009)

(A, top), Boy with right clubfoot treated in infancy by plaster cast applications and tendo-Achillis lengthening in another hospital and first seen by us at 5 years of age. Following manipulation and 3 plaster cast applications, the heel-cord was lengthened again and the anterior tibialis was transferred to the cuboid and the extensor hallucis longus was recessed to the neck of the first metatarsal. (B, bottom), At 19 years of age the right foot is well aligned with normal range of motion in all its joints except for limited ankle dorsiflexion to 10 degrees. The strength of the transferred anterior tibial is 5 +. The circumference of the right calf measures 2 inches less than the left. (C) Standing anteroposterior and lateral roentgenograms show mild supination in both feet. The right navicular is slightly wedge shaped.
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Related In: Results  -  Collection

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getmorefigures.php?uid=PMC2664437&req=5

Fig6: (A, top), Boy with right clubfoot treated in infancy by plaster cast applications and tendo-Achillis lengthening in another hospital and first seen by us at 5 years of age. Following manipulation and 3 plaster cast applications, the heel-cord was lengthened again and the anterior tibialis was transferred to the cuboid and the extensor hallucis longus was recessed to the neck of the first metatarsal. (B, bottom), At 19 years of age the right foot is well aligned with normal range of motion in all its joints except for limited ankle dorsiflexion to 10 degrees. The strength of the transferred anterior tibial is 5 +. The circumference of the right calf measures 2 inches less than the left. (C) Standing anteroposterior and lateral roentgenograms show mild supination in both feet. The right navicular is slightly wedge shaped.
Mentions: Roentgenograms of these feet rarely show a completely normal foot. Some flattening of the superior articular surface of the talus was observed in 18 cases, and in nearly all there was mild dorso-lateral wedging of the navicular. The navicular was normally aligned with the head of the talus in 33 feet; it was displaced slightly medially in 18 feet and laterally in 7. The talocalcaneal index (the sum of the talocalcaneal angles in the AP and lateral roentgenograms [2]) was within normal limits, from 40 to 85°, in 46 feet and was less than 40° in 12 feet (Figs. 5 and 6).Fig. 5A–B

View Article: PubMed Central - PubMed

ABSTRACT

This Classic article is a reprint of the original work by Ignacio V. Ponseti and Jeronimo Campos, Observations on Pathogenesis and Treatment of Congenital Clubfoot. An accompanying biographical sketch on Ignacio V. Ponseti, MD, is available at DOI 10.1007/s11999-009-0719-8 and a second Classic article is available at 10.1007/s11999-009-0720-2. This article is ©1972 by Lippincott Williams and Wilkins and is reprinted with permission from Ponseti IV, Campos J. Observations on Pathogenesis and Treatment of Congenital Clubfoot. Clin Orthop Relat Res. 1972;84:50–60.

Show MeSH
Related in: MedlinePlus