Vol 12 | Issue 1 | January - April 2026 Archives - International Journal of Paediatric Orthopaedics

The Gliding Surgical Drapes Near the Periarticular Region: A Potential Source of Surgical Contamination

DOI- https://doi.org/10.13107/ijpo.2026.v12.i01.262

Open Access License: CC BY-NC 4.0

Submitted: 23/09/2025; Reviewed: 19/10/2025; Accepted: 14/01/2026; Published: 10/02/2026

Authors: Md Zafar Iqbal MS Ortho [1], Anil Agarwal MS Ortho [1], Sunny Bhalla MS Ortho [1]

[1] Department of Paediatric Orthopaedics, Chacha Nehru Bal Chikitsalaya, Geeta Colony, New Delhi, India

Address of Correspondence

Dr. Md Zafar Iqbal,
Senior Resident, Department of Paediatric Orthopaedics, Chacha Nehru Bal Chikitsalaya, Geeta Colony, New Delhi, India
E-mail: docmdzafariqbal@gmail.com

Abstract

In surgeries involving joints and the adjacent area, maintaining a sterile field is essential for preventing postoperative infections. The responsibilities are heightened when the joint is required to be exposed. An often-overlooked source of contamination is the gliding motion of the drapes from manipulation of the limb during surgery. We found the movement akin to the tendon glide in contaminated animal bites, where movement draws pathogens deep into the joint, increasing the infection risk. This article presents a practical tip: recognizing this gliding drape as a surgical contaminant and suggesting methods to prevent it.
Keywords: Surgical drapes, Human/animal bite, Contamination, Sterility

References

1. Noordin S, McEwen JA, Kragh CJ Jr, Eisen A, Masri BA. Surgical tourniquets in orthopaedics. J Bone Joint Surg Am. 2009;91:2958-67.
2. Armstrong M, Spencer R. Tourniquet use in orthopaedic surgery. J Perioper Pract. 2011;21:319-22.
3. Tintle SM, Forsberg JA, Keeling JJ, Shawen SB. Infectious complications of animal bites involving the upper extremity. J Hand Surg Am. 2010;35:476-9.
4. Walsh EF, Ben-David D, Ritter M, Mechrefe A, Mermel LA, DiGiovanni C. Microbial colonization of tourniquets used in orthopedic surgery. Orthopedics. 2006;29:709-13.
5. Ahmed SM, Ahmad R, Case R, Spencer RF. A study of microbial colonisation of orthopaedic tourniquets. Ann R Coll Surg Engl. 2009;91:131-4.
6. Mufarrih SH, Qureshi NQ, Rashid RH, Ahmed B, Irfan S, Zubairi AJ, Noordin S. Microbial colonization of pneumatic tourniquets in the orthopedic operating room. Cureus. 2019;11:e5308.

How to Cite this Article: Iqbal MZ, Agarwal A, Bhalla S. The Gliding Surgical Drapes Near the Periarticular Region: A Potential Source of Surgical Contamination. International Journal of Paediatric Orthopaedics. January-April 2026; 12(1): 19-21.

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Small Shoulders, Big Burden: Scapular Osteomyelitis in an Infant

DOI- https://doi.org/10.13107/ijpo.2026.v12.i01.260

Open Access License: CC BY-NC 4.0

Submitted: 31/10/2025; Reviewed: 24/11/2025; Accepted: 11/01/2026; Published: 10/02/2026

Authors: Dyan D’ Souza MS, MCh (Paed Surgery) [1], Karthik Shyam MD Rad [2], Binu T Kurian MS Ortho [3], Shubha A M MS, MCh (Paed Surgery) [1]

[1] Department of Paediatric Surgery, St Johns National Academy of Health Sciences Bangalore, Karnataka, India
[2] Department of Radiodiagnosis, St Johns National Academy of Health Sciences Bangalore, Karnataka, India
[3] Department of Orthopaedics, St Johns National Academy of Health Sciences Bangalore, Karnataka, India

Address of Correspondence

Dr. Shubha A M,
Department of Pediatric Surggery, St Johns National Academy of Health Sciences Bangalore, Karnataka, India
E-mail: dramshubha@yahoo.co.in

Abstract

Background: A mass in relation to the scapula is rare in infancy, causing a diagnostic dilemma. We report a case in an infant presenting with scapular osteomyelitis and highlight the management of this condition.
Case report: A 2-month-old male child presented with an atraumatic swelling in the right scapular region with decreased movements of the upper arm for 15 days with no response to antibiotics. A diffuse firm to hard swelling in the right scapular region, with increased temperature and tenderness restricting both passive and active movements at the shoulder joint was noted on examination. Though total counts and C- reactive protein were raised, the blood culture was sterile. Plain X-ray and MRI revealed osteomyelitis of the right scapula. Biopsy further confirmed the diagnosis. Good response was noted to treatment with antibiotics and physiotherapy
Conclusion: A scapular mass without shoulder arthritis, longer duration of symptoms, negative cultures and the absence of sepsis are notable features in this case. Emphasis is on prompt diagnosis and treatment with antibiotics and appropriate physiotherapy to prevent long term complications.
Keywords: Infant, Scapula, Osteomyelitis, Antibiotics, Case report

References

1. Kennedy TL, Whitaker M, Pellitteri P, Wood WE. Cystic hygroma/lymphangioma: a rational approach to management. Laryngoscope. 2001 Nov;111(11 Pt 1):1929-37. doi: 10.1097/00005537-200111000-00011. PMID: 11801972.
2. Dich VQ, Nelson JD, Haltalin KC. Osteomyelitis in infants and children. A review of 163 cases. Am J Dis Child. 1975 Nov;129(11):1273-8. doi: 10.1001/archpedi.1975.02120480007004. PMID: 1190158.
3. Behnke NM, Patel M, Davidson T, Arkader A. Orthopaedic case of the month: Rapidly progressive shoulder soft tissue mass in an 8-week-old girl. Clin Orthop Relat Res. 2011 Feb;469(2):624-9. doi: 10.1007/s11999-010-1710-0. Epub 2010 Dec 3. PMID: 21128034; PMCID: PMC3018191.
4. De Boeck H. Osteomyelitis and septic arthritis in children. Acta Orthop Belg 2005;71:505–15.
5. Koubaa M, Mnif H, Zrig M, et al. Acute hematogenous osteomyelitis of the scapula in children. Orthop Traumatol Surg Res. 2009;95:632–635.
6. Cunningham DG. Hematogenous osteomyelitis of the scapula presenting as Erb’s palsy. Ill Med J. 1975;147:439–440.
7. Fardon DF. Osteomyelitis of the scapula in an infant. Case report. Mo Med. 1970 May;67(5):299-302. PMID: 5427692
8. Rose NK, Franck LG, Celestin B, Adoubs I, Jean Bertrand KA. Osteomyelitis of the scapula in a 2-month-old infant. J. Pediatr. Surg. Case Rep. 2021; 73: 101998.
9. Meena S, Ansari MT. Osteomyelitis of scapula with secondary septic arthritis of shoulder joint in a six-month-old child. Malays Orthop J. 2013 Mar;7(1):67-9. doi: 10.5704/MOJ.1303.001. PMID: 25722810; PMCID: PMC4341052
10. Obeidat MM, Omari A. Osteomyelitis of the scapula with secondary septic arthritis of the shoulder joint. Singapore Med J. 2010;51:1–2.
11. Dartnell J, Ramachandran M, Katchburian M. Haematogenous acute and subacute paediatric osteomyelitis: a systematic review of the literature. Bone Joint J. 2012;94-B:584–595.
12. Caffey J. Infantile cortical hyperostosis; a review of the clinical and radiographic features. Proceedings of the Royal Society of Medicine. 1957;50(5):347–354. doi: 10.1177/003591575705000516.
13. Unkila-Kallio L, Kallio MJ, Peltola H, Eskola J. Serum C-reactive protein, erythrocyte sedimentation rate, and white blood cell count in acute hematogenous osteomyelitis of children. Pediatrics. 1994;93(1):59–62.
14. Pratik Phansopkar, Priya tikhile, Radhika Sawal, et al. Early physiotherapy rehabilitation approach enhances recovery in rare acute tibial osteomyelitis post-operative in a 9year old child. Medical Science, 2020, 24(104), 2482-2486.

How to Cite this Article: D’ Souza D, Shyam K, Kurian BT, Shubha AM. Small Shoulders, Big Burden: Scapular Osteomyelitis in an Infant. International Journal of Paediatric Orthopaedics. January-April 2026; 12(1): 16-18.

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Chronic Recurrent Multifocal Osteomyelitis with Non-Contiguous Involvement of the Spine: A Case Report and Review of Literature

DOI- https://doi.org/10.13107/ijpo.2026.v12.i01.258

Open Access License: CC BY-NC 4.0

Submitted: 30/09/2025; Reviewed: 21/10/2025; Accepted: 09/12/2025; Published: 10/02/2026

Authors: S Kailash MS Ortho [1], Vijaysriram MS Ortho [1]

[1] Department of Paediatric Orthopaedics, Kanchi Kamakoti Child trust Hospital, Chennai, Tamil Nadu, India.

Address of Correspondence

Dr. S.Kailash,
Senior Consultant, Department of Paediatric Orthopaedics, Kanchi Kamakoti Child trust Hospital, Chennai, Tamil Nadu, India.
E-mail: kailasdoc2989@gmail.com

Abstract

Background: Chronic Recurrent Multifocal Osteomyelitis (CRMO) is a chronic non-bacterial osteomyelitis that affects children and adolescents.
Case Presentation: A 9-year-old previously healthy boy initially presented with vague abdominal pain, for which he was investigated but no active intervention was undertaken. There was increasing pain and deformity over the back noted a week later.
CT thorax was performed to identify the lesion in the rib and an open biopsy was done (resection of diseased rib and transverse process). Biopsy report was suggestive of chronic non-infective osteomyelitis (CRMO). A whole-body magnetic resonance imaging (MRI) showed an additional lesion in the right acetabulum. There was significant relief of symptoms with oral naproxen and intravenous Zoledronate.
At 15 years of age, there was no pain or deformity in the spine and vertebral lesion had reconstituted. The patient was asymptomatic.
Conclusion: CRMO is an under-diagnosed condition. A delay in the diagnosis can result in morbidity in the form of prolonged antibiotic therapy and multiple invasive investigations (biopsy). In most cases, it is a diagnosis of exclusion. This case of a boy with CRMO with main involvement of the spine is presented for its rarity.
Keywords: CRMO, Spine, Zolendronate, Osteomyelitis.

References

1. Yamashita K, Calderaro C, Labianca L, Gajaseni P, Weinstein SL. Chronic recurrent multifocal osteomyelitis (CRMO) involving spine: A case report and literature review. J Orthop Sci 2021;26:300-5.
2. Acikgoz G, Averill LW. Chronic recurrent multifocal osteomyelitis: typical patterns of bone involvement in whole-body bone scintigraphy. Nucl Med Commun. 2014;35:797–807.
3. Wipff J, Adamsbaum C, Kahan A, Job-Deslandre C. Chronic recurrent multifocal osteomyelitis. Joint Bone Spine 2011;78:555‐60.
4. Hofmann SR, Kapplusch F, Girschick HJ, et al. Chronic recurrent multifocal osteomyelitis (CRMO): presentation, pathogenesis, and treatment. Curr Osteoporos Rep. 2017;15:542–54.
5. Giedion A, Holthusen W, Masel LF, Vischer D. Subacute and chronic “symmetrical” osteomyelitis. Ann Radiol (Paris) 1972;15:329‐42.
6. Probst FP, Björksten B, Gustavson KH. Radiological aspect of chronic recurrent multifocal osteomyelitis. Ann Radiol (Paris) 1978;21:115‐25.
7. Huber AM, Lam PY, Duffy CM, Yeung RS, Ditchfield M, Laxer D, et al. Chronic recurrent multifocal osteomyelitis: Clinical outcomes after more than five years of follow-up. J Pediatr 2002;141:198‐203.
8. Prose NS, Fahrner LJ, Miller CR, Layfield L. Pustular psoriasis with chronic recurrent multifocal osteomyelitis and spontaneous fractures. J Am Acad Dermatol 1994;31:376‐9.
9. Wipff J, Costantino F, Lemelle I, Pajot C, Duquesne A, Lorrot M, et al. A large national cohort of French patients with chronic recurrent multifocal osteitis. Arthritis Rheumatol 2015;67:1128‐37.
10. Falip C, Alison M, Boutry N, Job-Deslandre C, Cotten A, Azoulay R, et al. Chronic recurrent multifocal osteomyelitis (CRMO): A longitudinal case series review. Pediatr Radiol 2013;43:355‐75.
11. Hospach T, Langendoerfer M, von Kalle T, Maier J, Dannecker GE. Spinal involvement in chronic recurrent multifocal osteomyelitis (CRMO) in childhood and effect of pamidronate. Eur J Pediatr 2010;169:1105‐11.
12. Batheja D, Munigangaiah S, Jayanna HH, Ghodke A. Contiguous Three- Level Vertebral Collapse in Thoracic Spine: A Novel Presentation of Chronic Recurrent Multifocal Osteomyelitis in 12 years old and Review of Literature. Journal of Orthopaedic Case Reports 2021 June;11(6): 57-62.
13. Sułko J, Ebisz M, Bień S, Błażkiewicz M, Jurczyk M, Namyślak M. Treatment of chronic recurrent multifocal osteomyelitis with bisphosphonates in children. Joint Bone Spine 2019;86:783‐8.
14. Kostik MM, Kopchak OL, Chikova IA, Isupova EA, Mushkin AY. Comparison of different treatment approaches of pediatric chronic non-bacterial osteomyelitis. Rheumatol Int. (2019) 39(1):89–96.
15. Zhao Y, Wu EY, Oliver MS, Cooper AM, Basiaga ML, Vora SS, et al. Consensus treatment plans for chronic nonbacterial osteomyelitis refractory to nonsteroidal antiinflammatory drugs and/or with active spinal lesions. Arthritis Care Res. (2018) 70(8):1228–37.

How to Cite this Article: Kailash S, Vijaysriram. Chronic Recurrent Multifocal Osteomyelitis with Non-Contiguous Involvement of the Spine: A Case Report and Review of Literature. International Journal of Paediatric Orthopaedics. January-April 2026; 12(1): 12-15.

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Pyomyositis of Iliacus in an Adolescent: A Case Report

DOI- https://doi.org/10.13107/ijpo.2026.v12.i01.256

Open Access License: CC BY-NC 4.0

Submitted: 17/10/2025; Reviewed: 06/11/2025; Accepted: 08/01/2026; Published: 10/02/2026

Authors: Kushagra Vashisht MS Ortho [1], Sudhir Rana MS Ortho [1], Parmanand Gupta MS Ortho [1]

[1] Department of Orthopaedics, Government Medical College and Hospital, Chandigarh, India

Address of Correspondence

Dr. Parmanand Gupta,
Department of Orthopaedics, Government Medical College and Hospital, Chandigarh, India
E-mail: drpgupta123@gmail.com

Abstract

Pyomyositis of the iliacus muscle is rare in children and adolescents. It has an overlapping presentation with septic arthritis of the hip or spondylodiscitis. A 15-year-old boy presented with progressive left hip pain, fever, and limp. T2 weighted MRI images revealed hyperintensities in the iliacus and piriformis muscles. Open surgical drainage was performed with postoperative antibiotics. Hip arthrotomy was not carried out. Complete healing with resolution of symptoms occurred at 2 weeks. This case highlights the importance of prompt imaging and surgical intervention in managing rare musculoskeletal infections, as well as the need for clinicians to maintain a high suspicion for pyomyositis adjacent to the hip joint and avoid unnecessary arthrotomy.
Keywords: Pyomyositis, Iliacus, Hip, Case report

References

1. Davidson D, Letts M, Khoshhal K. Pelvic osteomyelitis in children: a comparison of decades from 1980-1989 with 1990-2001. J Pediatr Orthop. 2003;23(4):514-521.
2. Beaupré A, Carroll N. The three syndromes of iliac osteomyelitis in children. J Bone Joint Surg Am. 1979;61(7):1087-1092.
3. Zvulunov A, Gal N, Segev Z. Acute hematogenous osteomyelitis of the pelvis in childhood: Diagnostic clues and pitfalls. Pediatr Emerg Care. 2003 Feb;19(1):29-31
4. Rand N, Mosheiff R, Matan Y, Porat S, Shapiro M, Liebergall M. Osteomyelitis of the pelvis. J Bone Joint Surg Br. 1993 Sep;75(5):731-3.
5. Mignemi ME, Menge TJ, Cole HA, Mencio GA, Martus JE, Lovejoy S, Stutz CM, Schoenecker JG. Epidemiology, diagnosis, and treatment of pericapsular pyomyositis of the hip in children. J Pediatr Orthop. 2014 Apr-May;34(3):316-25.
6. Central TB Division, Ministry of Health & Family Welfare, Government of India. (2017). Index-TB Guidelines: Guidelines on extrapulmonary tuberculosis for India. Indian Journal of Medical Research, 145(4), 448–463. Indian Journal of Medical Research.
7. Jain VK, Iyengar KP, Botchu R, Vaishya R. Sacroiliac joint tuberculosis revisited – A clinico-radiological review. J Clin Orthop Trauma. 2021 Nov 16;24:101707
8. An etiologic shift in infantile osteomyelitis: The emergence of the group B streptococcusEdwards, Morven S. et al. The Journal of Pediatrics, Volume 93, Issue 4, 578 – 583\
9. Nicole I. Montgomery, Howard R. Epps, Pediatric Septic Arthritis, Orthopedic Clinics of North America,Volume 48, Issue 2,2017,Pages 209-216
10. Eugen Cohen, Tiberiu Katz, Eldad Rahamim, Shlomi Bulkowstein, Yaron Weisel, Ron Leibovitz, Yariv Fruchtman, Eugene Leibovitz, Septic arthritis in children: Updated epidemiologic, microbiologic, clinical and therapeutic correlations, Pediatrics& Neonatology, Volume 61, Issue 3,2020,Pages 325-330
11. Kim EY, Kwack KS, Cho JH, et al. Usefulness of dynamic contrast enhanced MRI in differentiating between septic arthritis and transient synovitis in the hip joint. AJR Am J Roentgenol. 2012; 198:428–433.
12. Kirkhus E, Flato B, Riise O, et al. Differences in MRI findings between subgroups of recent-onset childhood arthritis. PediatrRadiol. 2011;41:432–440.
13. Mazur JM, Ross G, Cummings J, et al. Usefulness of magnetic resonance imaging for the diagnosis of acute musculoskeletal infections in children. J Pediatr Orthop. 1995;15:144–147.
14. Key role of magnetic resonance imaging in the diagnosis of infections around the hip and pelvic girdle mimicking septic arthritis of the hip in children. J Pediatr Orthop B. 2016 May;25(3):234-40.
15. Montgomery CO, Siegel E, Blasier RD, et al. Concurrent septic arthritis and osteomyelitis in children. J Pediatr Orthop. 2013;33: 464–467.

How to Cite this Article: Vashisht K, Rana S, Gupta P. Pyomyositis of Iliacus in an Adolescent: A Case Report. International Journal of Paediatric Orthopaedics. January-April 2026; 12(1): 08-11.

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Atypical Clubfoot- A Systematic Review

DOI- https://doi.org/10.13107/ijpo.2026.v12.i01.254

Open Access License: CC BY-NC 4.0

Submitted: 20/11/2025; Reviewed: 13/01/2026; Accepted: 02/02/2025; Published: 10/02/2026

Authors: Shabir A Dhar MS Ortho [1], Tahir Ahmed Dar MS Ortho [1], Reyaz Ahmed Dar MS Ortho [1], Abhishek Raina MS Ortho [1], Mohd Alam MS Ortho [1], Sabqat Farooq MS Ortho [1], Abdul Maajid MS Ortho [1]

[1] Department of Orthopaedics, SKIMS Medical College, Bemina, Srinagar, Kashmir, India.

Address of Correspondence

Dr. Shabir A Dhar,
Department of Orthopaedics, SKIMS Medical College, Bemina, Srinagar, Kashmir, India.
E-mail: shabirdhar@yahoo.co.in

Abstract

Background: The management of congenital talipes equinovarus (clubfoot) has been transformed by the Ponseti technique. However, 5-7% of clubfeet present as atypical or complex variants that are resistant to standard treatment protocols. These challenging cases require early recognition and modified management strategies.
Purpose: To systematically review the literature on atypical/complex clubfoot, defining its clinical characteristics, pathogenesis, and evidence-based treatment modifications.
Methods: A systematic literature search was conducted across PubMed, Embase, Scopus, and Ovid databases through April 2025. Studies reporting on atypical or complex clubfoot characteristics, pathogenesis, management techniques, and outcomes were included. Quality assessment and data extraction followed PRISMA guidelines. A total of 32 studies met the inclusion criteria and were analyzed.
Results: Atypical clubfoot is characterized by a deep transverse plantar crease, hyperextension of the big toe, and a stubby foot appearance. Complex variants demonstrate excessive oedema and stiffness during casting. The challenges encountered during treatment are due to intrinsic anatomical factors and iatrogenic factors such as frequent cast slippage. Key management modifications include: prevention of cast slippage through metatarsophalangeal joint termination, application of the Ponseti 2 manoeuver for forefoot equinus correction, delayed tenotomy timing, and increased vigilance for recurrence. Recurrence rates range from 15-45%, higher than idiopathic clubfoot. Long-term outcomes demonstrate satisfactory correction with modified protocols, though complex clubfoot requires more casts and closer follow-up.
Conclusions: Early recognition of atypical/complex clubfoot enables timely implementation of treatment modifications. Prevention of iatrogenic cast slippage, appropriate application of the Ponseti 2 manoeuver, and extended follow-up are essential for optimal outcomes. Further research is needed to standardize terminology and establish evidence-based algorithms.
Keywords: Clubfoot, Atypical, Complex, Review

References

1. Ponseti IV, Zhivkov M, Davis N, et al. Treatment of the complex idiopathic clubfoot. Clin Orthop Relat Res 2006;451:171-176.
2. Turco VJ. Recognition and management of the atypical idiopathic clubfoot. In: Simons GW, ed. The clubfoot: the present and a view of the future. New York, NY: SpringerVerlag, 1994:76-77.
3. Ponseti International Association. Clinical practice guidelines for the management of clubfoot deformity using the ponseti method; 2015. Available at: http://www.ponseti.info/. [Accessed 24 January 2018].
4. Masquijo J, Arana E. Complex clubfoot: my 5 tips for appropriate evaluation and treatment with the Ponseti method. Acta Ortop Mex. 2023; 37(4): 233-236.https://dx.doi.org/10.35366/113618
5. Dimeglio A, Bensahel H, Souchet P, Mazeau P, Bonnet F. Classification of clubfoot. J Pediatr Orthop. 1995;4:129–136.
6. Goldner JL, Fitch RD. Classification and evaluation of congenital talipes equinovarus. In: Simons GW, ed. The Clubfoot: The Present and a View of the Future. New York, NY: Springer-Verlag; 1994:120-139.
7. Lehman WB, Mohaideen A, Madan S, Scher DM, Van Bosse HJ, Iannacone M, Bazzi JS, Feldman DS. A method for the early evaluation of the Ponseti (Iowa) technique for the treatment of idiopathic clubfoot. J Pediatr Orthop B. 2003;12:133–140.
8. Pandey S, Pandey AK. Clinical classification of congenital clubfeet. In: Simons GW, ed. The Clubfoot: The Present and a View of the Future. New York, NY: Springer-Verlag; 1994:91-92.
9. Smythe T, Kuper H, Macleod D, Foster A, Lavy C. Birth prevalence of congenital talipes equinovarus in low- and middle-income countries: a systematic review and meta-analysis. Trop Med Int Health. 2017; 22(3): 269-85. doi: 10.1111/tmi.12833.
10. Göksan SB, Bursali A, Bilgili F, Sivacioğlu S, Ayanoğlu S. Ponseti technique for the correction of idiopathic clubfeet presenting up to 1 year of age. A preliminary study in children with untreated or complex deformities. Arch Orthop Trauma Surg 2006; 126:15–21.
11. Matar HE, Beirne P, Bruce CE, Garg NK. Treatment of complex idiopathic clubfoot using the modified Ponseti method: up to 11 years follow-up. J Pediatr Orthop B2017;26(2):137-42 doi:10.1097/BPB.0000000000000321[published Online First:Epub Date]|
12. Mandlecha P, Kanojia RK, Champawat VS, Kumar A. Evaluation of modified Ponseti technique in treatment of complex clubfeet. J Clin Orthop Trauma. 2019 May-Jun;10(3):599-608. doi: 10.1016/j.jcot.2018.05.017. Epub 2018 May 28. PMID: 31061597; PMCID: PMC6492221.
13. Mosca VS. Clubfoot pathoanatomy—biomechanics of deformity correction: a narrative review. Ann Transl Med 2021;9(13):1096 | https://dx.doi.org/10.21037/atm-20-7491.
14. Al-Mohrej OA, Alshaalan FN, Alhussainan TS. Is the modified Ponseti method effective in treating atypical and complex clubfoot? A systematic review. Int Orthop. 2021 Oct;45(10):2589-2597. doi: 10.1007/s00264-021-05092-4. Epub 2021 Jun 10. PMID: 34114108.
15. Sinha SK, Garg V, Singh V. The Tug Test and Modified Ponseti Casting: A Simple and Reliable Method to Improve the Efficacy of Casting in Complex Clubfoot. Indian J Orthop. 2023 May 30;57(7):1147-1152. doi: 10.1007/s43465-023-00910-w. PMID: 37384013; PMCID: PMC10293533.
16. Ibrahim S. Tincture of Benzoin to Prevent Cast Slippage in Clubfoot. Malays Orthop J. 2016 Nov;10(3):62-63. PMID: 28553455; PMCID: PMC5333691.
17. Rangasamy K, Baburaj V, Gopinathan NR, Behera P, Sudesh P, Ravi Subramanian S. Correction results of atypical clubfeet managed with modified Ponseti technique: A meta-analysis of 354 feet. J Clin Orthop Trauma. 2022 Jun 25;31:101939. doi: 10.1016/j.jcot.2022.101939. PMID: 35818375; PMCID: PMC9270237.
18. Dragoni M, Gabrielli A, Farsetti P, Bellini D, Maglione P, Ippolito E. Complex iatrogenic clubfoot: is it a real entity? J Pediatr Orthop B. 2018 Sep;27(5):428-434. doi: 10.1097/BPB.0000000000000510. PMID: 29578933.
19. Williams ML, Dobbs MB. Clubfoot: Emphasis on the Complex and Atypical Subsets. Clin Podiatr Med Surg. 2024 Jan;41(1):17-25. doi: 10.1016/j.cpm.2023.06.009. Epub 2023 Jul 18. PMID: 37951674.
20. Yoshioka S, Huisman NJ, Morcuende JA. Peroneal nerve dysfunction in patients with complex clubfeet. Iowa Orthop J 2010; 30:24–28.
21. Edmonds EW, Frick SL. The drop toe sign: an indicator of neurologic impairment in congenital clubfoot. Clin Orthop Relat Res. 2009;467:1238e1242. https://doi.org/10.1007/s11999-008-0690-9.
22. Mandlecha P, Kanojia RK, Champawat VS, Kumar A. Evaluation of modified Ponseti technique in treatment of complex clubfeet. J Clin Orthop Trauma. 2019 May-Jun;10(3):599-608. doi: 10.1016/j.jcot.2018.05.017. Epub 2018 May 28. PMID: 31061597; PMCID: PMC6492221.
23. Chu A, Nechamie H, Lehman WB. Management of complex clubfoot. November 2019Journal of the Pediatric Orthopaedic Society of North America 1(1) DOI:10.55275/JPOSNA-2019-39]
24. Allende V, Paz M, Sanchez S, Lanfranchi L, Torres-Gomez A, Arana E, Nogueira MP, Masquijo JJ. Complex Clubfoot Treatment With Ponseti Method: A Latin American Multicentric Study. J Pediatr Orthop. 2020 May/Jun;40(5):241-245. doi: 10.1097/BPO.0000000000001469. PMID: 31688820.
25. Loose O, Fernandez Fernandez F, Langendoerfer M, Wirth T, Eberhardt O. Complex, atypical clubfoot: follow-up after up to 16 years reveals a high risk of relapse but good functional and radiological outcomes. Arch Orthop Trauma Surg. 2023 Oct;143(10):6097-6104. doi: 10.1007/s00402-023-04840-y. Epub 2023 May 17. PMID: 37195434.
26. Agarwal A, Gupta S, Rastogi P. Hallux length and deep medial crease in complex clubfeet: Do they recover? J Clin Orthop Trauma. 2020 May-Jun;11(3):453-456. doi: 10.1016/j.jcot.2020.03.004. Epub 2020 Mar 11. PMID: 32405208; PMCID: PMC7211816.
27. Gupta A, Hakak A, Singh R, et al. Atypical clubfoot: early identification and treatment by modification of standard Ponseti technique. Int J of Adv Res. 2015;3:1229–1234.
28. Bozkurt C, Sarıkaya B, Sipahioglu S, Altay MA, Çetin BV. Using the modified Ponseti method to treat complex clubfoot: early results. Jt Dis Relat Surg. 2021;32:170e176. https://doi.org/10.5606/ehc.2021.77135.
29. Duman S, Camurcu Y, Cobden A, Ucpunar H, Karahan N, Bursali A. Clinical outcomes of iatrogenic complex clubfoot treated with modified Ponseti method. Int Orthop. 2020;44:1833e1840. https://doi.org/10.1007/s00264-020-04529-6.
30. Elseddik HM, Helal MM, Kholeif MM, Sherif MM. Modified Ponseti manipulation and casting technique for treatment of atypical clubfoot. Egypt Orthop J. 2018; 55: 123-7.
31. Addosooki A, Tammam H, Morsy AF, Marzouq A, Ahmed EH, Ahmed AM, Said E. Correction to: Correlation of radiographic parameters with clinical correction in idiopathic congenital talipes equinovarus undergoing Ponseti treatment. Int Orthop. 2022 Aug;46(8):1911. doi: 10.1007/s00264-022-05453-7. Erratum for: Int Orthop. 2021 Dec;45(12):3139-3146. PMID: 35612667.
32. Patel A, Mongia AK, Sharma RK, Saini R, Chaudhary C, Singh S. Outcome of Atypical & Complex Clubfoot Managed by Modified Ponseti Method-A Prospective Study. J Foot Ankle Surg. 2022 Sep-Oct;61(5):1081-1085. doi: 10.1053/j.jfas.2022.01.024. Epub 2022 Jan 26. PMID: 35184957.

How to Cite this Article: Dhar SA, Dar TA, Dar RA, Raina A, Alam M, Farooq S, Maajid A. Atypical Clubfoot- A Systematic Review. International Journal of Paediatric Orthopaedics. January-April 2026; 12(1): 02-07.

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