We conducted a prospective randomised controlled trial to compare the standard Ponseti plaster method with an accelerated method for the treatment of idiopathic congenital talipes equinovarus. The standard weekly plaster-change method was accelerated to three times per week. We hypothesised that both methods would be equally effective in achieving correction. A total of 40 consecutive patients (61 feet) were entered into the trial. The initial median Pirani score was 5.5 (95% confidence interval 4.5 to 6.0) in the accelerated group and 5.0 (95% confidence interval 4.0 to 5.0) in the standard control group. The scores decreased by an average 4.5 in the accelerated group and 4.0 in the control group. There was no significant difference in the final Pirani score between the two groups (chi-squared test, p = 0.308). The median number of treatment days in plaster was 16 in the accelerated group and 42 in the control group (p < 0.001). Of the 19 patients in the accelerated group, three required plaster treatment for more than 21 days and were then assigned to the standard control method. Of the 40 patients, 36 were followed for a minimum of six months.These results suggest that comparable outcomes can be achieved with an accelerated Ponseti method. The ability to complete all necessary manipulations within a three-week period facilitates treatment where patients have to travel long distances.

Level IV case series.

This was a retrospective review of 80 patients with unilateral slipped capital femoral epiphysis treated with either prophylactic fixation or observation. The unaffected hip of 44 patients (mean age 12.6 years) were subjected to simultaneous prophylactic fixation and 36 patients (mean age 13.4 years) were managed by observation. Fisher's exact test showed a significantly high incidence of sequential slip of unaffected hips in the observation group in comparison with prophylactic fixation (P=0.002). No cases had avascular necrosis or chondrolysis. Prophylactic fixation significantly reduces the incidence of sequential slip. It outweighs the minimal surgical risks compared with its benefit in the prevention of further sequential slip.

ObjectiveIn this study, we describe the experiences of individuals who received direct‐to‐consumer DNA test results indicating unexpected parentage.BackgroundThe availability of recreational DNA testing has left individuals navigating unexpected results with limited resources. Little is known about the emotional impact of learning about unexpected paternity.MethodsThis qualitative study used inductive thematic analysis of in‐depth interviews with adults (n = 27; age 40–70 years) who received direct‐to‐consumer DNA test results revealing unexpected biological paternity.ResultsIdentity transformation occurred while integrating DNA results. Themes included (a) initial discovery marked by shock, fear, crisis, and loss of genetic relatedness; (b) identity exploration encompassing anxiety, emotional challenges, determination to conduct genealogical research, and confronting family; (c) identity reconstruction due to new familial connections and reconciliation of personal and familial history; and (d) synthesis of and shift in worldview, impacting trust in kinship.ConclusionIdentity transformation after unexpected DNA results is often accompanied by intense change in personal and community identity and a shift in identity related to race, ethnicity, religion, family status, belonging, or other facets of one's self. Temporal trauma, grief, and loss are common outcomes. Isolation, shame, and a lack of emotional support are prevalent.ImplicationsThis research elucidates emotional processes related to learning unexpected DNA results.

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