Veleszületett strukturális dongalábbal élők életminőségét befolyásoló mennyiségi és minőségi tényezők

Abstract

Congenital talipes equinovarus (CTEV) is a common developmental disorder of considerable medical and social importance, whose treatment has only been partially successful up until recently. The European prevalence of the condition is approx. 1-2 per mil and the data of Hungarian Birth Defect Registry indicate a prevalence of 1.18 per mil between 2004 and 2009, which means an average of 116 new cases annually. Lately the international literature has mostly focused on the aetiology and treatment of the condition, as well as the functional results and effectiveness of the Ponseti method. When two different treatment methods are compared, the basis of comparison may prove to be challenging; similarly, who is supposed to determine the function of the lower limb – the doctor or the patient? It is also important to note who determined the effectiveness and what methods were used to compare the results. Specialists are divided by the methods of treatment, while researchers differ along the lines of objective and subjective assessment. As a result of scientific evidence, today the first line treatment is the Ponseti method and patients’ subjective assessment of the functional result has gained more importance. The first method of correction, developed by dr. Kite, involved extensive casting and surgery of the soft tissues. Ignacio Ponseti modified this technique by focusing on the manipulation of the talonavicular joint as part of the casting. Surgical intervention has been minimised to cutting the Achilles tendon, and a special orthosis (Denis-Browne splint) has to be worn for half a year. The first Hungarian reports of the Ponseti method were published by Sohárt, Gellért (2012), Szőke, György (2014) and Kiss, Sándor (2014), who applied the Pirani scoring system when assessing the effectiveness of the intervention. In chronic conditions, there is an increasing number of Hungarian quality of life measurement tools that researchers can use; however, as regards CTEV there are no general and diseasespecific quality of life questionnaires that could be used in the assessment of patients. Information on patients’ health and quality of life would be essential, though as the review of the international scientific literature justifies its role in the evaluation of treatment efficiency and comparison of treatment results.