Consultórios e Horários

Consultórios e Horários

Consultório Copacabana
HAND CARE - 3 feira de 1500 as 1700
Rua Xavier da Silveira 45, cob 01
Telefone 25218644 - 996422446

Consultório Barra
Ortobarra - 5·Feira de 14:00 as 18:00
Av. das Americas 3333 Sala 910
Telefone 3325-0870 / 3328-7182 3151-3000 / 3153-1574

segunda-feira, 25 de maio de 2015

Pé Torto - Resultado comparativo na Atrofia da Panturrilha entre método de Ponseti e a cirurgia clássica

Calf Circumference Discrepancies in Patients With Unilateral Clubfoot: Ponseti Versus Surgical Release

Fulton, Zachary BS*; Briggs, Dustin MD; Silva, Selina MD; Szalay, Elizabeth A. MD

Background: Talipes equinovarus is the most common congenital lower limb abnormality. Decreased calf size has been found to have negative impacts on patients’ subjective appraisals of long-term outcomes. This study compares calf circumference ratios in 2 groups of patients with unilateral clubfoot, those treated according to the Ponseti method and those treated with extensive surgery, to determine whether the current standard of care achieves better anatomic outcomes.
Methods: Patients >1 year after treatment for unilateral clubfoot were recruited during normal follow-up appointments and both calves were measured using a standardized protocol. A questionnaire concerning their treatment history was also completed. Data were analyzed by comparing calf circumference ratios between treatment modalities.
Results: Thirty-five patients with unilateral clubfoot were recruited after satisfying inclusion criteria. Twenty-four (69%) were included in the Ponseti-managed group, and 11 (31%) were in the extensive surgery group. The affected legs were on average 3% to 10% smaller than the control legs across all groups. The surgery group’s average calf ratio was significantly less at 90.8%±3.5% compared with 94.4%±3.3% in the Ponseti group.
Conclusions: The calf circumference of limbs affected by clubfoot is significantly smaller in those treated with extensive surgery as compared with those treated with the Ponseti method alone, with or without percutaneous tenotomy. This supports the Ponseti method as the standard of care for achieving the most favorable anatomic outcome.

Este trabalho conclui que ao final do tratamento, o método de Ponseti é menos danoso a criança que o tratamento cirúrgico convencional no quesito Atrofia de Pantuurrilha.