Author/Editor		Antolič, Vane
Title		Novosti pri zdravljenju prirojenega ekvinovarusa
Translated title		Recent advances in the treatment of congenital clubfoot
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 72, št. 9
Publication year		2003
Volume		str. 515-8
Language		slo
Abstract		Background. In the article the etiology and pathological changes in congenital clubfoot are described. The manipulation and casting technique according to Ponseti is presented: the foot is abducted with dorsiflexion of the first ray while pressure is maintained on the lateral aspect of the talar neck in front of the lateral maleolus. The additional skin incision in the line of Achilles tendon is no longer used and the Cincinatti incision is slightly modified in the posterior part of the foot. The operative reposition of the talanavicular joint is in most of cases no longer necessary because of the succesful manipulation and casting technique according to Ponseti. Consequently, the operative time is shortened. Conclusions. Due to recent advances in the treatment of congenital clubfoot patients stay in the hospital only 24 hour after surgery. However the course and result of congenital clubfoot remains to be impredictable to some degree, presumably etiological heterogenity.
Summary		Izhodišča. V članku so opisani etiologija in patološke spremembe pri prirojenem ekvinovarusu stopala. Opisan je nov način redresijskega mavčenja (po Ponsetiju), pri katerem je stopalo redresirano v abdukcijski položaj s pritiskom na vrat talusa lateralno, sprednji del stopala pa je v supinaciji. Pri kirurški tehniki smo opustili dodaten rez v poteku Ahilove tetive in modificirali polkrožno incizijo nad petnico. Zaradi uspešne repozicije talonavikularnega sklepa z novim načinom mavčenja operativna repozicija v glavnem ni več potrebna, čas operacije je zato krajši. Zaključki. Zaradi uvedenih novosti pri zdravljenju prirojenega ekvinovarusa po operaciji zadošča le 24-urna hospitalizacija. Kljub izpopolnjenem načinu zdravljenja ostaja potek zdravljenja ekvinovarusa do neke mere še vedno nepredvidjiv, najverjetneje zaradi heterogenosti etiologije.
Descriptors		CLUBFOOT IMMOBILIZATION CASTS, SURGICAL TREATMENT OUTCOME