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A Journal on Physical Medicine and Rehabilitation after Pathological Events

Official Journal of the Italian Society of Physical and Rehabilitation Medicine (SIMFER), European Society of Physical and Rehabilitation Medicine (ESPRM), European Union of Medical Specialists - Physical and Rehabilitation Medicine Section (UEMS-PRM), Mediterranean Forum of Physical and Rehabilitation Medicine (MFPRM), Hellenic Society of Physical and Rehabilitation Medicine (EEFIAP)
In association with International Society of Physical and Rehabilitation Medicine (ISPRM)
Indexed/Abstracted in: CINAHL, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
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Europa Medicophysica 1999 June;35(2):61-8

language: English

Congenital ­foot ­defects. Follow-up of 148 con­sec­u­tive cas­es, ­born in the ­years 1986-1997

D'Osualdo F. 1, Schierano S. 1, Chiandotto V. 2, Furlan R. 2

1 Child Rehabilitation Centre, Institute of Physical Medicine and Rehabilitation, ASS N. 4 “Medio Friuli”, Udine, Italy;
2 Department of Neonatology and Neonatal Intensive Care Unit, Azienda Ospedaliera Santa Maria del­la Misericordia (SMM), Udine, Italy


BACKGROUND: Numerous stud­ies ­have ­been con­duct­ed in sam­ples under­go­ing oper­a­tive treat­ment, where­as ­there are far few­er stud­ies in unse­lect­ed pop­u­la­tions or ­case ­series. For ­this rea­son, it is dif­fi­cult to inter­pret the ­results of ­either con­ser­va­tive or oper­a­tive meth­ods of treat­ment.
METHODS: Here we ­present a sam­ple of chil­dren ­with con­gen­i­tal ­foot defor­mities, con­sti­tut­ing a ­cohort of 148 con­sec­u­tive cas­es ­born in a 12-­year peri­od, ­seen short­ly ­after ­birth (­mean 3 ­days), and ­after a min­i­mum of 12 ­months. The char­ac­ter­is­tics of the ­cohort ­were com­pared ­with ­those of the oth­er ­babies ­born in the ­same peri­od. Treatment was ­based on ear­ly man­age­ment, paren­tal involve­ment and the use of ­mobile orthos­es.
RESULTS: The fol­low-up ­data ­regard all of the ­infants ­seen at the Nursery. In 92 cas­es the ­defect was bilat­er­al, for a ­total of 236 ­feet. There ­were 23 cas­es (18%) of supi­nat­ed equi­nov­ar­us (SEV), 50 cas­es (38%) of met­a­tar­sus var­us (MV), 46 cas­es (35%) of ­talipes calcaneovalgus (TC), and 29 cas­es (23%) pre­sent­ing ­minor ­defects. In 80% of ­these cas­es, man­age­ment was lim­it­ed to instruct­ing the par­ents or sev­er­al ses­sions of phys­i­cal ther­a­py. Only 12% ­were treat­ed ­beyond the ­third ­month of ­life. Conservative treat­ment was suc­cess­ful in all cas­es of TC, MV, ­first and sec­ond ­grade SEV, and 2 cas­es of ­third ­grade SEV. Operative treat­ment was nec­es­sary in ­only 4 cas­es of ­third ­grade SEV (7/34 SEV ­feet). Analysis of the sam­ple ­revealed a sig­nif­i­cant dif­fer­ence in the num­ber of uni- and bilat­er­al cas­es ­among the var­i­ous clin­i­cal ­forms and the ­absence of a ­strong rela­tion­ship ­with the fac­tors usu­al­ly asso­ciat­ed ­with an intra­ute­rine mal­po­si­tion ­such as birth­weight (BW), ­birth ­order and a ­twin ­birth.
CONCLUSIONS: The ­study con­firms the ben­e­fits of ear­ly man­age­ment and a con­ser­va­tive ­approach to con­gen­i­tal ­foot defor­mities. When sur­gery was per­formed, ­only ­minor inter­ven­tions ­proved nec­es­sary.

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