Avaliação transversal dos métodos terapêuticos do pé torto congênito equinovaro idiopático: controvérsias sobre a tenotomia do tendão calcâneo

• Autor(a) principal: Chaim, Renan Moukbel [UNIFESP]
• Data de Publicação: 2010
• Outros Autores: Silva, Fabio Assunção e [UNIFESP], Angelini, Felipe Bertelli [UNIFESP], Dobashi, Eiffel Tsuyoshi [UNIFESP], Andrade Júnior, Luiz Carlos de [UNIFESP], Blumetti, Francesco Camara [UNIFESP], Pinto, Jose Antonio [UNIFESP]
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Repositório Institucional da UNIFESP
• Texto Completo: http://dx.doi.org/10.1590/S0102-36162010000700006; http://repositorio.unifesp.br/handle/11600/6030
• topic: Clubfoot; Questionnaires; Achilles Tendon; Methods; Pé Torto; Questionários; Tendão do Calcâneo; Método

OBJECTIVE: There has been a lot of discussion regarding the treatment of congenital clubfoot (talipes equinovarus,) and Posenti's methodology currently seems to be the most rational, offering high rates of satisfactory results when compared to Kite's approach that prevailed in orthopedics until the end of the 90s. With the recent change of concepts, this study purports to analyze the profile of orthopedists treating this infirmity in Brazil, through a questionnaire used at the 39th Brazilian Congress of Orthopaedics and Traumatology, since such data is unknown in the Brazilian literature. METHODS: An investigative questionnaire was prepared to ascertain the treatment method used, the characteristics of the population studied, the results acquired with treatment and, particularly, how they approached the Achilles tendon. RESULTS: Of the 5,329 registered orthopedists, we acquired 539 spontaneous participations. Of these, only 88 (16.30%) orthopedists perform the treatment for congenital clubfoot; 78 (88.60%) use the Ponseti method and 9 (10.20%) use Kite's; for 47.70%, conservative treatment is performed between 4 and 6 months and for 35.30%, between 1 and 3 months; 58 (66.00%) interviewees perform the Achilles tendon tenotomy in 80% to 100% of their patients and 59 (67.05%) perform it at a surgical center due to safety conditions, sterilized environment, anesthesia, ease of access, and patient monitoring; 32 (36.36%) orthopedists present 80% of good results or more, 54 (61.36%) present 50% to 80% good results and 46 (52.27%) present a 10% relapse rate. CONCLUSIONS: Although the Ponseti Method defines that the Achilles tendon tenotomy should be performed in an outpatient setting, most of the orthopedists (59 - 67.05%) perform it in the operating room.