Multiple Serial Casting for Recurrent Clubfoot in Arthrogryposis Corrects Deformity With Diminishing Returns

Arthrogryposis multiplex congenita (AMC) consists of more than 400 conditions involving severe joint contractures of at least two or more body regions. Management of clubfoot in patients with AMC is notoriously challenging, with a higher likelihood of recurrence than idiopathic clubfoot, which can b...

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Bibliographic Details
Published in:Curēus (Palo Alto, CA) CA), 2024-02, Vol.16 (2), p.e54398-e54398
Main Authors: Henstenburg, Jeffrey M, Sutliff, Nikki, Rompala, Alexander, Stutman, Amanda, Akhnoukh, Kyrillos M, Van Bosse, Harold J, Nossov, Sarah B
Format: Article
Language:English
Subjects:
Age
Ankle
Foot diseases
Intervention
Orthopedics
Patients
Pediatrics
Statistical analysis
Surgery
Variance analysis
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Summary:Arthrogryposis multiplex congenita (AMC) consists of more than 400 conditions involving severe joint contractures of at least two or more body regions. Management of clubfoot in patients with AMC is notoriously challenging, with a higher likelihood of recurrence than idiopathic clubfoot, which can be treated using the Ponseti technique to avoid or delay more invasive procedures. The purpose of this study is to determine the utility of multiple serial casting as a treatment of clubfoot in AMC using Pirani scores as an objective measure of deformity. Pirani scores were retrospectively collected from 17 AMC patients with a total of 30 clubfeet and two years follow-up from initiation of treatment. Patients with a minimum of three casting series were included. Pre-treatment and post-treatment deformity scores were examined across casting series using analysis of variance (ANOVA) statistical analysis. The first series pre-treatment Pirani score improved from 4.80±1.54 to 1.68±1.48 (p
ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.54398