Ponseti Method for clubfoot

NewsBot · Dec 20, 2024

Factors responsible for dropout in the Ponseti method of clubfoot treatment: A cross-sectional study
Manzoor et al
Qatar Med J. 2024 Nov 11;2024(4):63.

Background
The Ponseti method for clubfoot treatment is a non-surgical treatment with a successful outcome. However, many children are not able to complete Ponseti treatment due to various barriers and are termed dropout children. This study aimed to find out the factors responsible for dropout from clubfoot treatment in Peshawar, Pakistan.

Methods
The study was conducted in the Clubfoot Department of a tertiary care hospital. Clinical and demographic information like age, casting phase, bracing phase, and clubfoot types, i.e., idiopathic, syndromic, or neurogenic, were extracted from the hospital database, while for dropout factors, a semi-structured questionnaire was used. Descriptive statistics were applied to demographic data, assessments, and semi-structured questionnaires for parents. The association of dropout rates with age, gender, and unilaterally/bilaterally clubfoot was analyzed through chi-square tests.

Results
Between December 2017 and December 2022, a total of 1,150 babies were treated with the Ponseti method in the Clubfoot Department. Of 1,150 patients, 197 (17.1%) patients dropped out of the treatment. Twenty-four (12.1%) patients of this dropout were from the casting phase, and 173 (87.9%) patients were from the bracing phase. Age was found to be a significant factor affecting dropout from the Ponseti method. No significant association was found between the patient’s dropout and gender or between dropout and unilaterally/bilaterally clubfoot.

Conclusion
The Ponseti method improves clubfoot treatment but faces high dropout rates due to barriers like lack of family support and transport issues. Clinics addressed this by offering family support, transportation aid, telemedicine, community outreach, financial aid, peer support, and extended hours, reducing dropout rates and enhancing outcomes.
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NewsBot · Dec 26, 2024

Assessment of Gross Motor Skills in Ponseti-treated Children With Idiopathic Clubfoot at 3 Years Old: Insights from the Peabody Developmental Motor Scale 2
Rice, Samuel W. BS et al
Journal of Pediatric Orthopaedics 44(9)e846-e851, October 2024. | DOI: 10.1097/BPO.0000000000002771

Background:
Congenital talipes equinovarus, or clubfoot, can lead to lifelong functional impairments, including diminished gross motor skills (GMS), if left untreated. The Ponseti method corrects idiopathic clubfoot through casting and bracing. Given the importance of GMS in childhood development, this technique must be optimized to support childhood and long-term health outcomes. This study examined immediate posttreatment GMS in 3-year-old children treated with Ponseti, hypothesizing that they would perform on par with their nonclubfoot peers.

Methods:
Data from 45 children (33 to 46 mo of age) treated for idiopathic clubfoot were analyzed. The Peabody Developmental Motor Scales, 2nd edition, was used to assess GMS, and logistic regression identified factors influencing Gross Motor Quotient (GMQ) scores.

Results:
Approximately half (n=22) of the patients exhibited below-average GMS (11th to 25th percentile), with 11 scoring below the 10th percentile. Initial deformity severity, gender, and cast numbers did not impact GMQ. Repeat percutaneous tenotomy was associated with lower GMQs. Brace compliance significantly reduced odds of low GMQs by up to 80%. Age at testing and additional surgery were also linked to below-average and poor GMQs.

Conclusions:
GMS appeared to be impaired in almost half of the 3-year-old patients treated for idiopathic clubfoot, so our hypothesis was disproven. Repeat percutaneous tenotomy was associated with lower GMS, necessitating future recognition of patients who might be at risk of relapse. Brace noncompliance emerged as a significant risk factor, emphasizing early identification of these patients and education for their parents. This study offers a benchmark for clinicians and parents, but research on long-term outcomes is needed.
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NewsBot · Jan 10, 2025

Comparison between unilateral and bilateral clubfoot treated with Ponseti method at walking age: static and dynamic assessment
Marco Sapienza et al
J Pediatr Orthop B. 2024 Oct 1.

This study evaluated the static, postural, dynamic, and clinical outcomes among five groups of patients: a bilateral CTEV (congenital talipes equinovarus) group treated with tenotomy (n = 14), bilateral CTEV group treated conservatively (n = 6), unilateral CTEV group treated with tenotomy (n = 7), unilateral CTEV group treated conservatively (n = 3), and control group (n = 20). Data were collected through baropodometric examinations and clinical evaluations using Pirani, clubfoot assessment protocol, foot and ankle disability index (FADI), and American Orthopedic Foot and Ankle Society scores. Bilateral CTEV patients treated with tenotomy showed no statistically significant differences compared to healthy controls. Significant differences were found in lateral-lateral variation in the bilateral postural group (P = 0.002) and in static peak pressure in unilateral tenotomy patients (P = 0.046). Dynamic comparisons revealed significant differences in mean pressure between unilateral groups (P = 0.002) and lateral-lateral variation in bilateral groups (P = 0.004). The Pirani score showed significant differences between tenotomy-treated and postural patients (P = 0.000). Statistically significant differences in FADI scores were found between bilateral groups (P = 0.0037), between tenotomy-treated groups (P = 0.0020), and between the bilateral tenotomy-treated group and the unilateral postural group (P = 0.021). Bilateral CTEV patients treated with tenotomy develop static and dynamic values comparable to healthy controls. Bilateral patients develop better dynamic values compared to patients with a unilateral variant
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Ponseti Method for clubfoot

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Ponseti Method for clubfoot

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

Looking for Forensic Podiatry: Principles and Methods, Second Edition

LQDCELL Method from Puma

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Slower runners benefit most from elite methods

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Share This Page

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