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Functional physiotherapy method results for the treatment of idiopathic clubfoot

World Journal of Orthopedics 2019年第6期10卷 235-246页

作者： noriela carmen garcia-gonzalez Jorge Hodgson-Ravina Armando Aguirre-Jaime Servicio de Rehabilitacion Servicio de Ortopedia y TraumatologiaUnidad de Investigacion Clinica y ExperimentalHospital Universitario Nuestra Senora de CandelariaSanta Cruz de Tenerife 38010Spain Colegio de Enfermeria Laureate International UniversitiesSanta Cruz de Tenerife 38001Spain

BACKGROUND Idiopathic clubfoot is a congenital deformity of multifactorial *** initial treatment is eminently conservative;one of the methods applied is the Functional physiotherapy method(FPM),which includes different approaches:Robert Debré(RD)and Saint-Vincent-de-Paul(SVP)among *** method is based on manipulations of the foot,bandages,splints and exercises adapted to the motor development of the child aimed to achieve a plantigrade and functional *** hypothesis was that the SVP method could be more efficient than the RD method in correcting deformities,and would decrease the rate of *** To compare the RD and SVP methods,specifically regarding the improvement accomplished and the frequency of surgery needed to achieve a plantigrade *** Retrospective study of 71 idiopathic clubfeet of 46 children born between February 2004 and January 2012,who were evaluated and classified in our hospital according to severity by the Dimeglio-Bensahel *** included moderate,severe and very severe ***-four feet were treated with the RD method and 37 feet with the SVP *** outcomes at a minimum of two years were considered as very good(by physiotherapy),good(by percutaneous heel-cord tenotomy),fair(by limited surgery),and poor(by complete surgery).RESULTS Complete release was not required in any case;limited posterior release was done in 23 cases(74%)with the RD method and 9(25%)with the SVP method(P<0.001).The percutaneous heel-cord tenotomy was done in 2 feet treated with the RD method(7%)and 6 feet(17%)treated with the SVP method(P<0.001).Six feet in the RD group(19%)and twenty-one feet(58%)in the SVP group did not require any surgery(P<0.001).CONCLUSION Our study provides evidence of the superiority of the SVP method over the RD method,as a variation of the FPM,for the treatment of idiopathic clubfoot.

关键词： Congenital clubfoot Clubfeet Talipes equinovarus Conservative treatment Physical therapy Physiotherapy techniques Conservative methods

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