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Treatment in opposition to helminths inside Norwegian sheep: the questionnaire-based study.
Radiological results showed improvement in 20 feet, while 2 feet showed no improvement. The improvement was significant in Lat. T1MT (P ‹ 0.001), AP-T1MT (P  0.05). Conclusion The results of the present study showed that the procedure reliably relieves pain in PPV foot in CP children and proved effective in addressing all components of the deformity in both hindfoot and forefoot clinically and Radiologically. © 2018.Introduction The commonly techniques for anterior tibial tendon transfer (ATTT) for clubfoot are split transfers (Hoffer), whole transfers to cuboid (Garceau) or 3rd cuneiform (Ponseti). We compared these surgical ATTT methods for relapsed clubfoot. Material and methods Thirty relapsed clubfoot (46 feet) patients initially treated with Ponseti casting technique were prospectively randomized for ATTT techniques. The outcome was evaluated in terms of foot inversion, eversion and ankle dorsiflexion. Results Average follow up was 5.49 months. Whole transfers had better absolute ankle dorsiflexion than split transfers. Foot inversion was comparable in Hoffer and Ponseti transfers but better with Garceau transfers. https://www.selleckchem.com/products/plx8394.html For eversion, best values occurred with Ponseti transfers. Absolute values of ankle dorsiflexion, foot inversion and eversion obtained with spilt transfers were less than those obtained with whole transfers (statistically insignificant). Conclusions No significant differences for foot or ankle function could be detected in this study using the various surgical ATTT techniques in short term follow up. © 2018.Introduction Various clubfoot severity scoring systems are known to us. Dimeglio and Pirani Scoring systems are most widely used. Also, various treatment outcome measures have been proposed by researchers to assess patient satisfaction and results of treatment. None of the available methods are widely popular and amenable for routine use. A "nwdps protocol" was proposed for functional assessment of patients with clubfoot correction, where "n" was no pain during walking or running; "w" was ability to wear normal shoes; "d" was no significant difference in foot/shoe size of both sides; "p" was plantigrade foot and "s" was ability of the child to squat without heel lift-off. The aim of this study was to test this functional outcome assessment tool for easy day to day use post clubfoot correction. Methods The nwdps protocol was applied to all the children at followup on a yearly basis who underwent clubfoot deformity correction in Department of Orthopaedics of our Institute between March 2016 and January 2018. Results Eighty children were enrolled for the study, 45 had bilateral affection while 35 had unilateral affection. In all 125 feet were treated for clubfoot correction and evaluated using nwdps protocol. Each child was assessed by 2 researchers independently. There was no difference in functional assessment of 2 observers. Fifty-nine children were nwdp positive, one was nwps positive, while 2 were dwps positive at the end of 1 year. 79 children became nwdps positive at the end of 2nd year of followup. Conclusion Nwdps protocol is a very easy to remember and easy to use functional outcome assessment tool post clubfoot correction with high degree of objectivity and interobserver reliability. Level of evidence Level IV. © 2019 Delhi Orthopedic Association. All rights reserved.Background We examined the correlation between initial Pirani and Dimeglio scores and their individual components to the number of casts for older clubfoot children. Methods Twenty seven patients (39 feet) aged 2-11 years with idiopathic clubfeet were treated using the Ponseti technique and correlation with number of corrective casts calculated. The number of cast required was counted from application of primary cast to the time of initiation of the foot abduction orthosis. Results Average 8.45 ± 2.31 (range, 4-13) casts were used for treatment. A low correlation (r = 0.203) was identified when total Dimeglio score was compared with the number of casts. No correlation was identified for Pirani score (r = 0.023). Among individual components, only cavus deformity had a significant positive correlation to cast numbers. Conclusions The Pirani and Dimeglio classifications still remain the most widely practiced clubfoot severity grading systems for the older clubfoot child. However, their prognostic value to predict the total cast duration from initial severity remains questionable. © 2019 Delhi Orthopedic Association. All rights reserved.Introduction Serial Ponseti casting achieves deformity correction in early presenting idiopathic clubfoot cases normally in around 7 casts. However, there are resistant patients where correction requires more casts than usual. In such patients a modification in standard technique might be required right from the beginning. Such patients were collectively called as difficult clubfoot. The aim of this study was to assess the outcome of our modification to Ponseti technique in difficult clubfoot. Methods All idiopathic clubfoot cases who were 75th percentile or more in WHO age for weight chart (chubby infants) or untreated clubfoot patients presenting for first time to our clinic at more than 5 months age (late presenters and neglected cases) were included in the study. Patients who had been previously surgically intervened elsewhere, patients over 7 years of age, patients with syndromic clubfoot or clubfoot associated with neurological conditions were excluded from the study. The patients were treated by early tenotomy of tendoachillis and a plantar fascia release before starting serial casting by Ponseti technique. Post correction, strict bracing protocol was followed with regular follow up. Pirani scoring was done at each stage. Measurement of Talocalcaneal angle on AP radiograph, maximum degree of abduction and dorsiflexion was noted once every year. Results There were total 28 patients in our study. In all, 47 feet were subjected to modified Ponseti protocol. There were 21 male patients. Median age at presentation was 4 months. Mean centile of weight for age as per WHO growth chart was 64. Mean Pirani score at presentation was 5.86 (S.D. ± 0.34). Mean number of casts required for correction was 3.75 ± 1.10. Maximum followup period was 25 months. Conclusion This modification of Ponseti casting for difficult clubfoot patients achieves correction in shorter duration with less number of casts. © 2019 Delhi Orthopedic Association. All rights reserved.
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