PubMed · 15202186
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Jon G Divine, Timothy E Hewett. 2004. Taking the load off.. https://pubmed.ncbi.nlm.nih.gov/15202186/
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Clubfoot is the commonest congenital deformity in babies. More than 100,000 babies are born worldwide each year with congenital clubfoot. Around 80% of the cases occur in developing nations. We treated 154 feet [mean Pirani score (total) 5.57] in 96 children (78 males, 18 females) by the Ponseti method from January 2003 to December 2005. A prospective follow-up for a mean duration of 19.5 months (range 6-32 months) was undertaken. After six months of treatment the Pirani score was reduced to zero for all patients. The results show that corrective surgery, sometimes multiple, can be avoided in most cases which are usually associated with the development of a stiff, painful foot. Low socio-economic status and illiteracy prevailing in developing nations increases the prevalence of neglected clubfoot that is still harder to correct. Integration into various programs and proper use of available resources can decrease neglected clubfoot and improve chances of successful and timely correction of deformity. Bracing constitutes an important part of treatment and proper motivation and education of the parents mitigates the chances of losing correction. The Ponseti method of correcting clubfoot is especially important in developing countries, where operative facilities are not available in the remote areas and well-trained physicians and personnel can manage the cases effectively with cast treatment only.
A new valgus brace was evaluated in 15 patients with medial osteoarthritis of the knee and a varus leg axis. Significant improvement of pain and function were found after 6 weeks of brace treatment. Gait analysis showed that the brace had a tendency of lowering the peak varus moment about the knee. This effect was more profound in the presence of higher initial varus deformity angle of the knee. Furthermore, bracing led to a small decrease of knee extension at the end of the swing phase and an increase of walking velocity. The mechanisms identified by gait analysis in this study may be of clinical importance for future developments in brace treatment.
BACKGROUND: Transverse overcurvature of the nail is a painful condition that has been treated by conservative and/or surgical methods. OBJECTIVES: We sought to evaluate the efficacy of a plastic device for treatment of transverse overcurvature of the nail and to use a practical method (plaster mold) to evaluate follow-up of nail widening during and after treatment. METHODS: Twenty-five patients with transverse overcurvature of the nail were treated with placement of a plastic device. Pain assessment was done on a monthly basis. Nail improvement was evaluated through photographs and measurement of widening by plaster molds. RESULTS: Relief of pain could be determined in almost 100% of the cases in a 3-month period. Widening of overcurvature of the nail occurred in all cases. The plaster mold allowed a practical measurement of improvement in nail shape. CONCLUSION: The plastic device is an effective, safe, noninvasive, and inexpensive treatment option for overcurved nails. The plaster mold is a practical method to evaluate improvement in nail shape.