3+4+Supplementum/2012 - Společnost pro pojivové tkáně

tus, b) varus deformity and c) the equines
deformity, 3. if necessary Achilles elongation
according to Ponseti, 4. the whole treatment
should last for about 8–10 months of
age. The last two months (before walking) is
the time for consolidating for a good result,
5. in some percent (stiff-stiff deformation),
children outside of Lublin with insufficient
of conservative treatment before, need a full
operational program, 6. the “W” shape skin
cut – is important for future heeling – it
make possible to fully cover the wound, 7.
in some cases it is very important primary
transposition (transfer) of TA to lateral side
of foot, 8. cutting skin in “W” shape (Fig
in presentation) is an important achievement
in the surgical treatment of clubfoot,
because you can cover any wound, even
such when the correction produced a large
skin defect (Fig in presentation).
Conclusions
1. Treatment of congenital clubfoot need
experiences of team
2. Correction casting (manipulation + plaster
of Paris) should begin in 1–2 day
after birth
3. Ponseti way of Achilles elongation is
important element of treatment of clubfoot
deformity
4. Treatment must last up to 8–10 months
of age, when the child begin to walk
5. In surgery only “Lublin skin incision” is
proper and gave good result
6. Primary transfer of TA (tibialis anterior
muscle/tendon) is important in some
children
7. We must remember that in 5 % – 8 %
of children with club foot has coincidentally
(mild) paresis cerebrals infant
form, other words – MBD (minimal
brain dysfunction).
ambul_centrum@volny.cz
8. The result in the years 1995–2012 were:
very good 60 %, good 20 %, sufficient
10 %, insufficient 10 % with residual
adduction and varus of forefoot.
Literature by the authors
aBSTRakT
SYMPTOMaTiC TReaTMenT Of
GeneTiC SkeleTal diSORdeRS
Marik Ivo1) , Myslivec Radek2) , Marikova Alena1) ,
Smrcka Vaclav1) Ambulant Centre for defects of Locomotor
apparatus, Prague, Czech Republic
1) Ambulant Centre for Defects of Locomotor
Apparatus, Olšanská 7, 130 00 Prague 3, Czech
Republic
E-mail: ambul_centrum@volny.cz
2) Ortopaedic-Traumatologic Department ON
Příbram a.s., U nemocnice 84, Příbram, 261 01,
Czech Republic
introduction
The lecture summarizes longstanding
experience of the authors with the comprehensive
treatment of skeletal dysplasias (SD)
and genetic disorders. Primary SD result
from mutated genes that are expressed in
chondro-osseous tissue. Secondary SD are
caused by abnormalities of extraosseous
factors with secondary effects on skeletal
system i.e. metabolic, enzymatic and hormonal
disorders. Incidence is estimated
0.30–0.45 per 1000 live birth. In last years,
rapid advances have been made in identifying
chromosomal locus and/or the molecular
changes responsible for definition of
conditions that help further understand
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