- 作者：C. Martos-Mora ; catalinamartosmora@gmail.com ; J. Gentil-Ferná ; ndez ; J.A. Conejero-Casares ; R. Ramos-Moreno
- 关键词：Metatarso aducto congé ; nito ; Clasificació ; n ; Tratamiento
- 刊名：Rehabilitaci贸n
- 出版年：2012
- 期刊代码：pca300_00487120
- 类别：med
- 出版时间：April-June, 2012
- 卷：46
- 期：2
- 页码：127-134
- 文件大小：1099 K
Objective
This study proposes to make a clinical and therapeutic classification for congenital metatarsus adductus in order to unify criteria for diagnosis and treatment as well as to anticipate a prognosis.
Material and methods
We selected 87 patients (144 feet) that were classified according to their severity:
Grade 1: forefoot adduction. Total correction of the deformity.
Grade 2: forefoot adduction and inversion. Convex outer edge (palpable first metatarsal base). Concave inner edge. Normal longitudinal arch. Partial correction.
Grade 3: Grade 2 associated with transverse grooves. Uncorrectable.
We treated level 1 with stimulation and manipulation. For grade 2 and 3 we applied stimulation, manipulation and corrective dressing, adding braces and straight-last boots (optional in grade 2). We performed a statistical study to identify cases that needed treatment, its duration and efficacy.
Results
The 73 feet of grade 1, 55 grade 2 and 16 grade 3 of our series were treated as indicated. Total correction was achieved in 137 feet. Overall duration of treatment was 4.65 months, correction period 2.98 and monitoring was 8.57 months. These parameters were significantly associated (P<.05) with the degree of impairment.
Conclusions
The percentage of total corrections and the fact that none of our patients required the use of casts or surgery makes us consider that our protocol is acceptable.