Document Detail

The incidence and treatment of rocker bottom deformity as a complication of the conservative treatment of idiopathic congenital clubfoot.
MedLine Citation:
PMID:  18160500     Owner:  NLM     Status:  MEDLINE    
Rocker bottom deformity may occur during the conservative treatment of idiopathic congenital clubfoot. Between 1975 and 1996, we treated 715 patients (1120 clubfeet) conservatively. A total of 23 patients (36 feet; 3.2%) developed a rocker bottom deformity. It is these patients that we have studied. The pathoanatomy of the rocker bottom deformity is characterised by a plantar convexity appearing between three and six months of age with the hindfoot equinus position remaining constant. The convexity initially involves the medial column, radiologically identified by the talo-first metatarsal angle and secondly by the lateral column, revealed radiologically as the calcaneo-fifth metatarsal angle. The apex of the deformity is usually at the midtrasal with a dorsal calcaneocuboid subluxation. Ideal management of clubfoot deformity should avoid this complication, with adequate manipulation and splinting and early Achilles' percutaneous tenotomy if plantar convexity occurs. Adequate soft-tissue release provides satisfactory correction for rocker bottom deformity. However, this deformity requires more extensive and complex procedures than the standard surgical treatment of clubfoot. The need for lateral radiographs to ensure that the rocker bottom deformity is recognised early, is demonstrated.
G Koureas; V Rampal; E Mascard; R Seringe; P Wicart
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of bone and joint surgery. British volume     Volume:  90     ISSN:  0301-620X     ISO Abbreviation:  J Bone Joint Surg Br     Publication Date:  2008 Jan 
Date Detail:
Created Date:  2007-12-27     Completed Date:  2008-05-08     Revised Date:  2010-11-10    
Medline Journal Info:
Nlm Unique ID:  0375355     Medline TA:  J Bone Joint Surg Br     Country:  England    
Other Details:
Languages:  eng     Pagination:  57-60     Citation Subset:  AIM; IM    
Department of Paediatric Surgery, Saint-Vincent-de-Paul Hospital (APHP), 74-82 avenue Denfert-Rochereau, 75674 Paris Cedex 14, France.
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MeSH Terms
Ankle Joint / pathology
Child, Preschool
Clubfoot / therapy*
Foot Deformities, Acquired* / etiology,  radiography,  therapy
Infant, Newborn
Manipulation, Orthopedic / adverse effects*,  methods
Observer Variation
Retrospective Studies
Treatment Outcome

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