1. AuthorsDr. Fernando Garcia Cal Filho*, MD.; Dr. Roberto Guarniero, PhD** Authors: Dr. Fernando Garcia Cal Filho*, MD.; Dr. Roberto Guarniero, PhD** Rui Maciel, PhD**; Lucas Cortizo Garcia*; Fernanda Cortizo Garcia* Rui Maciel, PhD**; Lucas Cortizo Garcia*; Fernanda Cortizo Garcia* * Children's Hospital Martagão Gesteira – Salvador – Bahia - Brazil * Children's Hospital Martagão Gesteira – Salvador – Bahia - Brazil **Institute of Orthopedics and Traumatology, Faculty of Medicine, University of São Paulo (IOT FMUSP) COMPRESSION SYNDROME IN THE SURGICAL TREATMENT OF CONGENITAL CLUBFOOT - CASE REPORT. COMPRESSION SYNDROME IN THE SURGICAL TREATMENT OF CONGENITAL CLUBFOOT - CASE REPORT.

2. COMPRESSION SYNDROME IN THE SURGICAL TREATMENT OF CONGENITAL CLUBFOOT - CASE REPORT. INTRODUCTION In our department the access of Cincinnati began to be used with this propose since 1990. From the year 2000, after the revaluation of the technique used until then, we developed a standardize of the release of the damaged structures on the clubfoot, through a sequenced surgical technique. The objective of this presentation is demonstrate care when you choose the open surgical treatment, in congenital clubfoot and even with all the risk, the result is very good, as deformity correction. IDENTIFICATION NAME: B.C.M. GENDER: FEMALE AGE: 05 YEARS OLD MARCH: ALREADY STARTED PATHOLOGY: CONGENITAL CLUBFOOT RESISTANT BASE PATHOLOGY : ARTHROGRYPOSIS

3. COMPRESSION SYNDROME IN THE SURGICAL TREATMENT OF CONGENITAL CLUBFOOT - CASE REPORT. HISTORY PONSETTI FOR 04 MONTHS AND ABANDONED BY TWO YEARS BEGAN TREATMENT AGAIN TO 04 YEARS OF AGE. NOW USED BY THE METHOD OF KITE 08 MONTHS. OPERATED FOR 05 YEARS OF AGE: USED FOR ACCESS TO SURGERY TECHNIQUE ASSOCIATED Codevilla RELEASE SOFT PARTS OF MCKAY mod. AFTER SURGERY FOR TARGETED parent and CARE OF NOTICE OF BLOOD PURFUSÃO ENDS. DAY SURGERY 18/12/2010. The only communicate PARENTS OF INFUSION OF BAD RIGHT PODPDÁCTILOS 20/12/2010 DAY, FOR 08 HOURS OF THE MORNING. 20/12/2010 DAY TO SEE THE INFUSION OF COMMITTED 3, 4 AND 5 toes, ASSOCIATED WITH A LOT OF PAIN, IT WAS DONE OUT OF COMPLETE ITEMS WOUND SURGERY DONE AND DRAINAGE OF LARGE HEMATOMA. THERE WAS AN IMMEDIATE IMPROVEMENT OF STAINING OF PERFUSION toes and DORSAL REGION OF THE MIDDLE-RIGHT FOOT. The patient was admitted for Initiating the use of antibiotic medication (ceftriaxone + Oxacillin FOR 15 DAYS).

4. COMPRESSION SYNDROME IN THE SURGICAL TREATMENT OF CONGENITAL CLUBFOOT - CASE REPORT. TREATMENT TREATMENT AFTER THE DIAGNOSIS OF COMPRESSIVE SYNDROME: INITIALLY: INITIALLY: A RECALL OF INFUSION MEDIUM AND FOREFOOT - Made daily with dressing germ (chlorhexidine) and saline. R foot SECOND : SECOND : PREPARE THE SKIN FOR THE USE OF A FREE GRAFT - made areas debridement of skin necrosis and subcutaneous tissue, until the formation of granulation. Under general anesthesia, Made the debridement of necrotic tissue and wound dressing with ointment silver sulfadiazine 1% + Curatec®. Is kept with a splint to Maintain correction of deformity CORRECTED. Dec20, 2010

5. COMPRESSION SYNDROME IN THE SURGICAL TREATMENT OF CONGENITAL CLUBFOOT - CASE REPORT. TREATMENT THIRD THIRD : FREE GRAFT PLACEMENT OF TISSUE GRANULATED: All with tissue granulated and without infections is placed a free skin graft on all fabrics of Granular region dorsal and posteromedial foot. FINAL RESULT FINAL RESULT : use of orthotics right foot. Left foot with scarring OK. DONOR AREA

6. COMPRESSION SYNDROME IN THE SURGICAL TREATMENT OF CONGENITAL CLUBFOOT - CASE REPORT. BY THE AUTHORS INDICATE THIS SURGICAL CORRECTION OF RESISTANT CLUBFOOT CONSERVATIVE TREATMENT USING ACCESS CODEVILLA, PROVIDED THAT KEEP THE PATIENT HOSPITALIZED UNDER DIRECT OBSERVATION OF MEDICAL AND NURSING. MUST MAKE USE OF A DRAINAGE (Aspirators 3.2 mm), TO IS NOT IN THE UNPLEASANTNESS OF SURPRISE. CONCLUSION