Hungarian Radiology

[Birth Anniversary of György Benkő MD 1913-1972]

HORVÁTH László

JANUARY 20, 2003

Hungarian Radiology - 2003;77(01)

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Hungarian Radiology

[The 9th ESSR Congress Valencia, 11-12 October 2002 Hungarian President to Lead the Society]

NÉMETH Éva

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[Ultrasonographic twin peak sign]

JAKOBOVITS Ákos

[INTRODUCTION - Author describes ultrasonographic twin peak sign in order to differentiate dichorial-diamniotic from monochronic-diamnotic pregnancy in early gestation. In case of dichorial pregnancy the chorial tissue is forming a triangle shape. In case of monochorial twins the two amnion layers are forming a ”T” shape. CASE REPORT - The first case represents a dichorionic pregnancy, while the second case is an example of monochorionic placental formation. CONCLUSION - The twin peak sign has clinical significance, because dichorionic pregnancies carry less risk of gestational and labor complications.]

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LOMBAY Béla

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PORUBSZKY Tamás

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KULKA Janina, CSERNI Gábor, PÉNTEK Zoltán

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KISS Sándor, TEREBESSY Tamás, HORVÁTH Nikoletta, DOMOS Gyula, GRESITS Orsolya, SZŐKE György

[INTRODUCTION - Congenital clubfoot is a severe developmental disorder. Without treatment, only the lateral border of the foot can be loaded and the sole faces the contralateral side. Good results can usually be achieved with early redression by serial casting (generally from the first week after birth) followed by extensive surgery at age six months (Achilles tendon lengthening, capsulotomy of the talo-crural and subtalar joints). The above procedure has been revolutionised by the method described by Ignacio Ponseti based on his own experiences, which has modified the casting technique and has also radically changed the surgical intervention. In this paper we report our experiences with Ponseti’s method and draw attention to this less invasive procedure. PATIENTS AND METHODS -The essence of Ponseti’s techniqe is reposition of the talonavicular joint, for which the foot is corrected in a different way compared with previous practice. Following redression for 8-10 weeks, percutaneous complete Achilles tenotomy is performed and the foot is fixed for further three weeks. A special orthesis is worn in the following 6 months for 24 hours a day and the same ortézis is suggested for overnights afterwards. In our institution, 171 clubfeet (45 unilateral, 126 bilateral; 84 right, 87 left; 25 girls, 83 boys) were treated between 2007 and 2012. Our results were evaluated with the help of the Pirani score, which is a widely used method for assessment of clubfoot treatment. RESULTS - Results were evaluated at the beginning of the treatment, at the end of redression and after percutaneous Achilles tenotomy. Pirani scores were 4.54±1.30; 1.48±1.02 and 0.59±0.45 respectively. The average dorsal flexion of the ankle joints was 23±12 degrees. CONCLUSION - Our own observations support the good results published in the literature, therefore the less invasive Ponseti method is suggested for the primary treatment of congenital clubfoot.]