Ortopedia Infantil y Lesiones Deportivas: Discusión entre pares / 2 hrs old pt with CTEV foot left....can we start serial pop casting rt now.....what is the current recommendation of ponseti method ......??????

miércoles, 17 de septiembre de 2014

Discusión entre pares / 2 hrs old pt with CTEV foot left....can we start serial pop casting rt now.....what is the current recommendation of ponseti method ......??????

Indian-Orthopaedic Research-Group

DrUmesh Kumar

2 hrs old pt with CTEV foot left....can we start serial pop casting rt now.....what is the current recommendation of ponseti method ......??????

2 hrs old pt with CTEV foot left....can we start serial pop casting rt now.....what is the current recommendation of ponseti method ......??????

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DrUmesh Kumar @Ujagar singh ji...No true shortening in left LL. ..

14 de septiembre a la(s) 9:42 · Me gusta
Bhuwan Singh Started no

14 de septiembre a la(s) 9:43 · Me gusta
Bhuwan Singh Started now

14 de septiembre a la(s) 9:43 · Me gusta
Ujagar Singh Then it's ok...

14 de septiembre a la(s) 9:52 · Me gusta
Dhirendra Vikram Singh If skin is not so thin as in premature baby ..start serial manupulations..if so then better to avoid cast n demonstrate her mother maupulation..

14 de septiembre a la(s) 9:55 · Me gusta · 3
Owais Ahmed Qureshi Start ASAP but take care of the skin......no harm in waiting for 2 weeks

14 de septiembre a la(s) 9:57 · Me gusta · 2
Ali Abdelreheim Ali Omara Examine the hip for DDH and examine the leg then foot then start manipulation then ponsetti method if skin will not tolerate but better start casting

14 de septiembre a la(s) 9:59 · Me gusta
Shameem Ahmad In such a young baby casting to be done with leucoplast not pop

14 de septiembre a la(s) 10:01 · Me gusta
Rudra Narayan Pandey DrUmesh Kumar
Boss
Casting should be started as soon as the baby is brought to you but we are tought to start after a week for two reasons...
1. POP disturbs the mother and baby contact. The new born should be in close contact with mother...psychological and hormonal effects.
2. The new borns has very delicate skin...POP can damage it.

You know up to two years ponseti works well... there is no harm in delaying for a week or so.
You still have ample of time. Give mother time to recover from post partum effect and baby to know her/ his mother

14 de septiembre a la(s) 10:13 · Editado · Me gusta · 8
Paul Antony You can start serial casting any time we used start after 1 to 2 weeks. More important thing is that if the baby is too small. After 5 serial casting you will not get the proper Size DB shoes. This is very important. We are facing this situation some times

14 de septiembre a la(s) 10:17 · Me gusta · 2
Vivek Shrivastava Start as soon as possible preferably today,as time pass child become more cranky and gets difficulties in cooperation.

14 de septiembre a la(s) 10:20 · Me gusta
DrAbdulrahman Obied You can. .

14 de septiembre a la(s) 10:32 · Me gusta
Suman NV start after 1 week. first concern is baby's skin will be delicate and fragile. you can ask mother to manipulate the foot while breast feeding for 1 week

14 de septiembre a la(s) 10:35 · Me gusta · 1
Paul Antony Does manipulation by mother initially has any role. So many of the colleagues write manipulation by mother. actually no need

14 de septiembre a la(s) 10:37 · Me gusta · 1
Alok Shrivastava Yes you can

14 de septiembre a la(s) 10:44 · Me gusta
Nand Lal Jhamaria start corrective cast from day one

14 de septiembre a la(s) 10:50 · Me gusta
Warid Altaf Yes u can

14 de septiembre a la(s) 10:53 · Me gusta · 1
Sanjay Joseph Ponsetti alone will suffice as long as the mother is compliant.

14 de septiembre a la(s) 10:55 · Me gusta
Jay Sharma No casting for atleast 1 months age

14 de septiembre a la(s) 11:12 · Me gusta · 1
Viswanath Naik we start from 10th day

14 de septiembre a la(s) 11:13 · Me gusta
Edward Nazareth Wait for at least two weeks..

14 de septiembre a la(s) 11:23 · Me gusta
Bhupendra Bharti wait atleast for 2 weeks(skin condition). no harm to wait.

14 de septiembre a la(s) 11:25 · Me gusta
Krishna Pandey Wait for one month .explain manipulation before that.

14 de septiembre a la(s) 11:47 · Me gusta
Ayush Kumar Singhal Manipulation by mother till 15 days of age then serial casting

14 de septiembre a la(s) 11:52 · Me gusta · 2
Ismail Fathalla Is his knee ok?

14 de septiembre a la(s) 11:54 · Me gusta · 1
Naresh Goyal Not now...after 15 days

14 de septiembre a la(s) 12:13 · Me gusta
Manoj Prasad Gupta said within few days,probably let ,fall of umblical cord..

14 de septiembre a la(s) 12:18 · Me gusta · 2
Verghese Joe Ponseti can begin on day 1, but usually a gap of a week is given.. So that the mother is given an opportunity to bond with the child and also so that she learns to maintain hygiene.

14 de septiembre a la(s) 12:22 · Me gusta · 3
Islam Al-rajabi Ponsetii from first day of life

14 de septiembre a la(s) 12:53 · Me gusta · 1
Gaurav Singh a week gap is not a problem..but explain mother about doing serial stretching of the foot..

14 de septiembre a la(s) 12:54 · Me gusta · 1
Nadir Shah Thr s no litreture supporting d exact time to start ponseti, it shd b started as soon as possible considering d baby's skin it differs to institute to institute n people to people,but yes mother shd b taught manipulation till casting s started..

14 de septiembre a la(s) 12:56 · Me gusta · 1
Siva K. Mani Teach mother manipulation n continue for 2 weeks.. Then corrective casting

14 de septiembre a la(s) 13:08 · Me gusta
Ramendra Narain Singh Ponsetti

14 de septiembre a la(s) 13:30 · Me gusta
Mavv Prasad Strapping first every 3 rd day casting after 6 weeks

14 de septiembre a la(s) 14:40 · Me gusta
Ahmed Elsawaf Sur you can

14 de septiembre a la(s) 14:53 · Me gusta
DrMithilesh Gupta if skin condition allows, ponsetti casting should be started as soon as possible after birth

14 de septiembre a la(s) 19:42 · Me gusta · 2
Mohamed Adel it maybe positional due to position of baby in uterus,is it flexible or not if flexible and return to normal position easily no need for cast and serial stretching is done

14 de septiembre a la(s) 20:13 · Me gusta
Avishek Ray Ghatak Accelerated Ponseti...5day intervals...check global-health.org for procedure...probably require 5-6 casts...TA tenotomy a must to prevent recurrence of equinus...most importantly, educate the patient party of the requirement of a correct Foot Abduction Orthosis...after serial casting...Left foot 70 degree abduction...Right 45 degree...and the hours of wear...22/24hours...den Night n Nap protocol...I feel the biggest problem with recurrences is lack of patient education...parents come back saying that the shoes have become too small or the child refuses to wear them....

14 de septiembre a la(s) 21:56 · Me gusta · 5
DrHariprasad Chowdary Munnangi I accept with Dr. Rudra.
Ponseti is wonderful technique.
casting can b started 2 weeks later. Teach mother about serial stretchings till then.
Ponseti cast can b changed at weekly basis.
Parent education is very important. They shud follow ur orders till 3 yrs. orelse recurrence may occur.
I prefer percut tenotomy in most of my cases.
All the best.

14 de septiembre a la(s) 22:35 · Me gusta · 2
Suneet Rajshekhar Can delay upto 1 month....manipulation to be started now

15 de septiembre a la(s) 0:28 · Me gusta
Shrikrishna Dhone initially corrective strapping by sticking plaster,followed by corrective sequential plasters

15 de septiembre a la(s) 0:37 · Me gusta
Ashish Agrawal i start with after a week...till time stretching my mother

15 de septiembre a la(s) 2:31 · Me gusta
Ashish Agrawal plz explain the procedure for tenotomy

15 de septiembre a la(s) 2:32 · Me gusta
Pavankumar Ravi please rule out secondary causes before labeling it as idiopathic club foot, if idiopathic clubfoot then its your choice how early you want to cast based on your comfort levels with casting without anaesthesia, earlier better...

15 de septiembre a la(s) 4:10 · Me gusta · 1
Pavankumar Ravi As Dr. Ashish has rightly pointed always do tenotomy after achieving an abduction of about 70 degrees

15 de septiembre a la(s) 4:12 · Me gusta
Dr-Abhi Kshatriya wait for Atleast 15 days.....then go for a cast...till then manipulation is required
.

15 de septiembre a la(s) 6:44 · Me gusta
Santosh Mahapatra Ponseti has not given any guideline about when to start but should be started as soon as possible... and 2 hr is too young and skin might be too soft to start. Can be waited up to 2 wk and then start.

15 de septiembre a la(s) 6:55 · Me gusta · 1
P Rajasekhar Rao after two weeks u need to start serial casting as of now u can do softissue stretches

15 de septiembre a la(s) 10:04 · Me gusta
Rajesh Bhat Till 2 wk stretching by mother. After that serial casting. Later if required tenotomy.

15 de septiembre a la(s) 11:37 · Me gusta
Tejbir Singh Arora We can start correction right away but serial casting in two weeks time

15 de septiembre a la(s) 12:07 · Me gusta
Ravi Bisht after on week ..... I've done and it is safe.

15 de septiembre a la(s) 13:29 · Me gusta
Avishek Ray Ghatak Is there any evidence to suggest that Ponseti's casting interferes with mother child bonding...or skin problems related to the casting technique...Ben Sahel's strapping seems to be a temporising method here...which I cannot fathom why...mother manipula...Ver más

15 de septiembre a la(s) 14:21 · Me gusta · 1
Pedro Jorba I have never had skin problems when using Ponseti casts in newborns; proper padding will prevent it

15 de septiembre a la(s) 15:00 · Me gusta

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