Incidence and risk factors for iatrogenic distal tibia/fibula fracture during Ponseti technique of clubfoot treatment. Issue 6 (November 2019)

• Record Type: Journal Article
• Authors: Ranjan, Rahul; Sud, Alok; Adhikary, Debashis; Sinha, Abhinav; Chand, Suresh
• Is Part Of: Journal of pediatric orthopedics. Volume 28:Issue 6(2019)
• Publication Date: 2019-11
• Subjects: clubfoot -- complication -- distal tibia/fibula fracture -- Ponseti technique -- risk factors; Pediatric orthopedics -- Periodicals; 618.927005
• DOI: 10.1097/BPB.0000000000000595
• Languages: English
• ISSNs: 1060-152X

Abstract

Abstract : The incidence and risk factors of distal tibia/fibula fracture, an uncommon complication during Ponseti manipulation, are unknown. We evaluated 222 virgin clubfeet of patients aged less than 3 years for fractures of distal tibia/fibula. Incidence rate was found to be 1.3% per year. Associated risk factors were identified as neglected, syndromic clubfeet, feet requiring greater than 10 casts, post-tenotomy dorsiflexion less than 10° and casting by physician with less than 3 years of casting experience, with odds ratios of 14, 28, 4.9, 3.7 and 3.4, respectively. Most of these fractures healed without consequences; however, it is still advisable not to forcefully dorsiflex while casting, which may result in the fracture of distal tibia/fibula.