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Neglected Idiopathic Bilateral Clubfoot Successfully Treated with the Ponseti MethodA Case Report
Davi de Podestá Haje, MD, PhD1
1 Hospital de Base do Distrito Federal and Centro Clínico Orthopectus, SMHN – Q. 2 Bl. A, Sala 804, Edificio de Clinicas, Asa Norte 70710-904, Brasilia-DF, Brazil. E-mail address for D.P. Haje: davihaje@yahoo.com.br
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Investigation performed at the Hospital de Base do Distrito Federal and Centro Clínico Orthopectus, Brasilia, Brazil



Disclosure: The author received no payments or services, either directly or indirectly (i.e., via his institution), from a third party in support of any aspect of this work. Neither the author nor his institution has had any financial relationship, in the thirty-six months prior to submission of this work, with any entity in the biomedical arena that could be perceived to influence or have the potential to influence what is written in this work. Also, the author has not had any other relationships, or engaged in any other activities, that could be perceived to influence or have the potential to influence what is written in this work. The complete Disclosures of Potential Conflicts of Interest submitted by authors are always provided with the online version of the article.

Copyright © 2013 by The Journal of Bone and Joint Surgery, Inc.
JBJS Case Connector, 2013 Jan 23;3(1):e9 1-4. doi: 10.2106/JBJS.CC.L.00144
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Extract

The treatment of neglected clubfoot or congenital talipes equinovarus (CTEV) in patients nearing skeletal maturity is usually performed by means of talectomy, Ilizarov distraction osteogenesis, arthrodesis, or osteotomy associated with soft-tissue release1-4. The treatment of idiopathic CTEV with the Ponseti method was initially recommended for infants before walking age, with good results reported in several studies5,6. The treatment of CTEV with the Ponseti method in cases considered neglected was initially described by Lourenço and Morcuende, with good results in seventeen patients at a maximum age of eight years and ten months7. More recently, Khan and Kumar reported excellent results with the Ponseti method in twenty-five clubfeet of children over the age of seven years with neglected CTEV, with one patient at the age of eleven years and one month8. This case report demonstrates a unique therapeutic success in a young girl with previously untreated, neglected idiopathic bilateral clubfoot who started treatment with the Ponseti method at the age of twelve years and ten months. The patient’s family was informed that data concerning the case would be submitted for publication, and they provided consent.
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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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