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CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2021; 56(06): 683-688
DOI: 10.1055/s-0041-1735833
Artigo de Atualização
Pé e Tornozelo

Pé torto congênito – O método Ponseti é a solução definitiva?[*]

Article in several languages: português | English
Felippi Guizardi Cordeiro 
1   Instituto de Ortopedia e Traumatologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
,
Rodrigo Sousa Macedo 
1   Instituto de Ortopedia e Traumatologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
,
Bruno Sérgio Ferreira Massa 
1   Instituto de Ortopedia e Traumatologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
,
Patricia Moreno Grangeiro 
1   Instituto de Ortopedia e Traumatologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
,
Alexandre Leme Godoy-Santos 
1   Instituto de Ortopedia e Traumatologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
,
Túlio Diniz Fernandes 
1   Instituto de Ortopedia e Traumatologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
› Author Affiliations Suporte Financeiro Não houve suporte financeiro de fontes públicas, comerciais, ou sem fins lucrativos.
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Resumo

O pé torto congênito é uma das deformidades mais comuns ao nascimento. A inadequação ou ausência do tratamento provoca sérias limitações aos portadores desta condição. O tratamento inicial pelo método Ponseti garante resultados funcionais superiores a outras modalidades de tratamento propostas anteriormente, porém as recidivas e os pés negligenciados ainda são um desafio na atualidade. O entendimento da fisiopatologia da doença, da anatomia e biomecânica local e uma minuciosa avaliação clínica e radiológica dos pacientes são imprescindíveis para entendermos o limite do método e escolhermos o melhor tratamento.

Palavras-chave

deformidades do pé - pé torto/terapia - anormalidades congênitas - tratamento

* O presente trabalho foi desenvolvido no Instituto de Ortopedia e Traumatologia do Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil.




Publication History

Received: 29 July 2020

Accepted: 23 April 2021

Article published online:
07 December 2021

© 2021. Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • Referências

  • 1 Mathias RG, Lule JK, Waiswa G, Naddumba EK, Pirani S. Incidence of clubfoot in Uganda. Can J Public Health 2010; 101 (04) 341-344
    CrossrefPubMedGoogle Scholar
  • 2 Jowett CR, Morcuende JA, Ramachandran M. Management of congenital talipes equinovarus using the Ponseti method: a systematic review. J Bone Joint Surg Br 2011; 93 (09) 1160-1164
    CrossrefPubMedGoogle Scholar
  • 3 Moon DK, Gurnett CA, Aferol H, Siegel MJ, Commean PK, Dobbs MB. Soft-Tissue Abnormalities Associated with Treatment-Resistant and Treatment-Responsive Clubfoot: Findings of MRI Analysis. J Bone Joint Surg Am 2014; 96 (15) 1249-1256
    CrossrefPubMedGoogle Scholar
  • 4 Ponseti IV, Smoley EN. The classic: congenital club foot: the results of treatment. 1963. Clin Orthop Relat Res 2009; 467 (05) 1133-1145
    CrossrefPubMedGoogle Scholar
  • 5 Dobbs MB, Rudzki JR, Purcell DB, Walton T, Porter KR, Gurnett CA. Factors predictive of outcome after use of the Ponseti method for the treatment of idiopathic clubfeet. J Bone Joint Surg Am 2004; 86 (01) 22-27
    CrossrefPubMedGoogle Scholar
  • 6 Kruse L, Gurnett CA, Hootnick D, Dobbs MB. Magnetic resonance angiography in clubfoot and vertical talus: a feasibility study. Clin Orthop Relat Res 2009; 467 (05) 1250-1255
    CrossrefPubMedGoogle Scholar
  • 7 Merrill LJ, Gurnett CA, Siegel M, Sonavane S, Dobbs MB. Vascular abnormalities correlate with decreased soft tissue volumes in idiopathic clubfoot. Clin Orthop Relat Res 2011; 469 (05) 1442-1449
    CrossrefPubMedGoogle Scholar
  • 8 Ippolito E, De Maio F, Mancini F, Bellini D, Orefice A. Leg muscle atrophy in idiopathic congenital clubfoot: is it primitive or acquired?. J Child Orthop 2009; 3 (03) 171-178
    CrossrefPubMedGoogle Scholar
  • 9 Gelfer Y, Dunkley M, Jackson D. et al. Evertor muscle activity as a predictor of the mid-term outcome following treatment of the idiopathic and non-idiopathic clubfoot. Bone Joint J 2014; 96-B (09) 1264-1268
    CrossrefPubMedGoogle Scholar
  • 10 Little Z, Yeo A, Gelfer Y. Poor Evertor Muscle Activity Is a Predictor of Recurrence in Idiopathic Clubfoot Treated by the Ponseti Method: A Prospective Longitudinal Study With a 5-Year Follow-up. J Pediatr Orthop 2019; 39 (06) e467-e471
    CrossrefPubMedGoogle Scholar
  • 11 Hosseinzadeh P, Kelly DM, Zionts LE. Management of the Relapsed Clubfoot Following Treatment Using the Ponseti Method. J Am Acad Orthop Surg 2017; 25 (03) 195-203
    CrossrefPubMedGoogle Scholar
  • 12 Thomas HM, Sangiorgio SN, Ebramzadeh E, Zionts LE. Relapse Rates in Patients with Clubfoot Treated Using the Ponseti Method Increase with Time: A Systematic Review. JBJS Rev 2019; 7 (05) e6-e16
    CrossrefPubMedGoogle Scholar
  • 13 Ponseti IV, Campos J. The classic: observations on pathogenesis and treatment of congenital clubfoot. 1972. Clin Orthop Relat Res 2009; 467 (05) 1124-1132
    CrossrefPubMedGoogle Scholar
  • 14 Ippolito E, Dragoni M, Antonicoli M, Farsetti P, Simonetti G, Masala S. An MRI volumetric study for leg muscles in congenital clubfoot. J Child Orthop 2012; 6 (05) 433-438
    CrossrefPubMedGoogle Scholar
  • 15 Kerling A, Stoltenburg-Didinger G, Grams L. et al. The congenital clubfoot - immunohistological analysis of the extracellular matrix. Orthop Res Rev 2018; 10: 55-62
    PubMedGoogle Scholar
  • 16 Pierz KA, Lloyd JR, Solomito MJ, Mack P, Õunpuu S. Lower extremity characteristics in recurrent clubfoot: Clinical and gait analysis findings that may influence decisions for additional surgery. Gait Posture 2020; 75: 85-92
    CrossrefPubMedGoogle Scholar
  • 17 Farsetti P, Dragoni M, Ippolito E. Tibiofibular torsion in congenital clubfoot. J Pediatr Orthop B 2012; 21 (01) 47-51
    CrossrefPubMedGoogle Scholar
  • 18 Johnston II CE, Hobatho MC, Baker KJ, Baunin C. Three-dimensional analysis of clubfoot deformity by computed tomography. J Pediatr Orthop B 1995; 4 (01) 39-48
    CrossrefPubMedGoogle Scholar
  • 19 Ganesan B, Yip J, Al-Jumaily A. et al. A novel 3D evaluation method for assessing bone to bone relationships in clubfoot. Eur Rev Med Pharmacol Sci 2019; 23 (05) 1882-1890
    PubMedGoogle Scholar
  • 20 Stouten JH, Besselaar AT, Van Der Steen MCM. Identification and treatment of residual and relapsed idiopathic clubfoot in 88 children. Acta Orthop 2018; 89 (04) 448-453
    CrossrefPubMedGoogle Scholar
  • 21 Eidelman M, Kotlarsky P, Herzenberg JE. Treatment of relapsed, residual and neglected clubfoot: adjunctive surgery. J Child Orthop 2019; 13 (03) 293-303
    CrossrefPubMedGoogle Scholar
  • 22 Holt JB, Oji DE, Yack HJ, Morcuende JA. Long-term results of tibialis anterior tendon transfer for relapsed idiopathic clubfoot treated with the Ponseti method: a follow-up of thirty-seven to fifty-five years. J Bone Joint Surg Am 2015; 97 (01) 47-55
    CrossrefPubMedGoogle Scholar
  • 23 Morcuende JA, Dolan LA, Dietz FR, Ponseti IV. Radical reduction in the rate of extensive corrective surgery for clubfoot using the Ponseti method. Pediatrics 2004; 113 (02) 376-380
    CrossrefPubMedGoogle Scholar
  • 24 Peterson N, Prior C. Correction of the Neglected Clubfoot in the Adolescent and Adult Patient. Foot Ankle Clin 2020; 25 (02) 205-220
    CrossrefPubMedGoogle Scholar
  • 25 Bouchard M. Guided Growth: Novel Applications in the Hip, Knee, and Ankle. J Pediatr Orthop 2017; 37 (Suppl. 02) S32-S36
    CrossrefPubMedGoogle Scholar
  • 26 Loza ME, Bishay SN, El-Barbary HM, Hanna AA, Tarraf YN, Lotfy AA. Double column osteotomy for correction of residual adduction deformity in idiopathic clubfoot. Ann R Coll Surg Engl 2010; 92 (08) 673-679
    CrossrefPubMedGoogle Scholar
  • 27 Mubarak SJ, Dimeglio A. Navicular excision and cuboid closing wedge for severe cavovarus foot deformities: a salvage procedure. J Pediatr Orthop 2011; 31 (05) 551-556
    CrossrefPubMedGoogle Scholar
  • 28 Sølund K, Sonne-Holm S, Kjølbye JE. Talectomy for equinovarus deformity in arthrogryposis. A 13 (2-20) year review of 17 feet. Acta Orthop Scand 1991; 62 (04) 372-374
    CrossrefPubMedGoogle Scholar