Kunal Vij

Abstract

Introduction: Ponseti method has become the mainstay of congenital clubfoot treatment in children presenting at early age. The initial efficacy rate of Ponseti method reaches almost 100%. The Ponseti method is also effective in older children with varied degree of success and preventing open joint surgery in almost every case. The Pirani method of evaluating the deformity and treatment outcome is easy and fairly reproducible and corresponds to the functional outcome of the treated feet. Aim: The present study aims at elucidating the efficacy of Ponseti method of clubfoot correction in an inexperienced hand and evaluating the feasibility and worth of Pirani severity scoring system in deformity and treatment evaluation. Materials and Methods: This is a prospective study carried out ii our institution Shri Guru Ram Rain Medical College Dehradun, India over a period of 2 ½ years from June 2015 to December 2017 and includes 44 idiopathic Clubfeet corrective cast application at weekly interval as per Ponseti protocol and were assessed with Pirani scoring system. The cases were followed up regularly at least for 6 months. Results: Following Ponseti protocol, we were able to achieve success rate of 95.45%. We experienced only a few minor complications such as plaster sores and overcrowding of toes that too in initial phase of study. Conclusion: Ponseti method is truly the gold standard of clubfoot management. Using Ponseti method, one can expect to achieve almost 100% success rate. It is also fairly effective in older children though with varied outcome or can at least prevent open joint surgery in them. The Pirani scoring system is clinical based, easy to apply and is in sync with Ponseti method.  Keywords: Clubfoot, Ponseti method, Pirani score.

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Abstract

Introduction: Trigger finger is caused by irritation of the flexor tendon as it slides through the fibro-osseous sheath. Its surgical options include open and percutaneous minimally invasive methods. Aim: This study is aimed at elucidating the efficacy of percutaneous release of trigger finger. Materials and Methods: This is a prospective study carried out in our institution Shri Guru Ram Rai Medical College Dehradun, India over a period of 2 years from June 2015 to august 2017. This study includes 68 trigger finger and thumb of 58 patients between 28 to 64 years. Here percutaneous trigger finger release of A1 pulley was done with the help of 18G hypodermic needle under local anaesthetic cover as a day care procedure. Subsequently the patient was followed up at least for 3 months. Results: Symptoms were resolved completely in all patients. None had any serious complication. Only a few patients had minor temporary wound related complicationsand temporary stiffness. Conclusions: Percutaneous release of trigger finger is effective, convenient, cost effective day care surgery without any significant complications in skilled hands. Keywords: Trigger finger, Percutaneous.

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