Evaluasi Radiologis pada Pasien Idiopathic Clubfoot yang Diterapi dengan Metode Ponseti Di Rso Prof. Dr. R. Soeharso Surakarta

Oleh :
Muhammad Ariffudin - S5605086 -

Background: Idiopathic clubfoot is one of the most common problems in pediatric orthopaedics. The incidence about 1 to 2 per 1000 live birth. Treatment for clubfoot is remain controversial. The controversy caused by no standardized method to evaluate the treatment. The Ponseti method for treatment of idiopathic clubfoot involves manipulation, the use of serial cast, and percutaneus Achiles tenotomy in most cases and bracing with and abduction orthosis to prevent relapse. Although Ponseti recommended evaluation of the infant clubfoot strictly by palpation, many orthopedic surgeon still rely on radiograph for decision making during treatment. The aim of this study is to.evaluate Ponseti method on idiopathic clubfoot with radiological appearance. Method: We conduct the study at outpatient department of Prof. Soeharso Hospital Surakarta, since may 2009 until October 2009. After diagnosed as idiopathic clubfoot, radiograph examination were made on anteroposterior and full dorsoflexion lateral view. The radiograph examination begin before treatment and made after final casting, before bracing period. The anteroposterior talocalcaneal angle and talo 1st metatarsal were measured. On lateral view, talocalcaneal, tibiotalar and tibiocalcaneal also measured. The result before and after treatment then compared and statisticly tested. Result: 53 feet was evaluated from 37 patients. Anteroposterior view shows talocalcaneal angle before treatment with mean 11,9o become 35,5o after treatment. Talo 1st metatarsal angle shows initial number is 38,0 o, become - 4,24o after treatment. Lateral view shows talocalcaneal angle initial was 15,24 o become 39,3o after treatment. Tibiotalar angle shows initial was 116,4o become 89,5o aftertreatment. Tibiocalcaneal angle shows initial was 105,1o become 53,2o aftertreatment. Aftertreatment angles shows within normal limit, and the improvement are statisticly significant. Conclusions: The measured angles in anteroposterior and lateral view after ponseti method of treatment on clubfoot show good result. corrected on clinical evaluation is also give normal radiographic after treatment. Keywords: Idiopathic Clubfoot, Ponseti Method, Radiograph Evaluation, Soeharso Hospital