Evaluation of an accelerated Ponseti protocol for the treatment of talipesequinovarus in Nigeria

Ibraheem, Gbadebo; Adegbehingbe, Olayinka O; Babalola, OM; Agaja, SB; Ahmed, Bouziane; Olawepo, A; Medubi, M

doi:10.4314/ecajs.v22i1.4

Cited by 8 publications

(14 citation statements)

References 21 publications

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“…Three studies were classified as having a low risk of bias [ 2 , 11 , 15 ]. The other six were classified as having a high risk of bias [ 9 , 10 , 16 – 19 ].…”

Section: Resultsmentioning

confidence: 99%

“…The advantage of a shorter treatment duration is for the caregivers of the patients. Especially caregivers in low-income countries with limited access to healthcare centers are likely to benefit from a shortened casting period [ 2 , 11 , 16 , 23 ]. Other authors suggest that benefits of a shorter treatment are the reduced risk of skin problems, cast slipping and osteopenia [ 2 , 11 ].…”

Section: Discussionmentioning

confidence: 99%

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Influence of cast change interval in the Ponseti method: A systematic review

et al. 2018

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BackgroundClubfeet are commonly treated using the Ponseti method. This method involves weekly manipulation and casting which gradually corrects the position of the foot. However, the reasons for following a weekly interval are not clear.Question / PurposeThe aim is to investigate the influence of the cast change interval on treatment outcomes in the Ponseti method.MethodsWe performed a systematic review of comparative studies in which the cast change interval was varied. Scientific databases were searched for relevant publications, screened for eligibility and assessed for a risk of bias. A 'best evidence' synthesis tool was used to synthesize the results of the included studies and draw conclusions from relevant clinical outcomes.ResultsNine papers matched the inclusion criteria, which provided data of 587 subjects who had a total of 870 clubfeet. There is strong evidence for a positive relation between cast change interval and treatment duration. However, there is no evidence for any relation between the cast change interval and the required number of casts, tenotomy rate, required surgery or failure rate.ConclusionsAccelerated versions are as effective and safe as the traditional Ponseti method. However, more research is needed to assess the long-term results and to identify an optimal cast change interval.

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“…Three studies were classified as having a low risk of bias [ 2 , 11 , 15 ]. The other six were classified as having a high risk of bias [ 9 , 10 , 16 – 19 ].…”

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Influence of cast change interval in the Ponseti method: A systematic review

et al. 2018

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“…Characteristics of the eligible studies are presented in Table 2 and include children from one day old [ 21 ] to 10 years [ 24 ].…”

Section: Resultsmentioning

confidence: 99%

“…Change in the mean Dimeglio score was evaluated in one study [ 25 ] and frequency of initial severity was reported with the Harrold-Walker classification in two studies [ 26 , 27 ]. Other definitions of primary outcome included: the number of days in casts [ 21 ], number of patients treated without extensive surgery [ 25 ], a plantigrade foot [ 24 , 28 , 29 ], no residual deformity [ 30 ], deformity status compared to previous visits [ 31 ] and parent reported outcomes on impact of treatment [ 32 ]. Limited definition terms included “complete correction” [ 26 ] and “satisfactory outcome” [ 25 ].…”

Section: Resultsmentioning

confidence: 99%

“…Data extracted included authors, year of publication, type of study, sample size, age of participants, duration of follow up and reported measurement of treatment outcome. Two authors [ 20 , 21 ] were contacted to provide missing information. Where other forms of treatment were detailed or where a paper included a country outside of sub-Saharan Africa, only data regarding the Ponseti method and from the sub-Saharan African country were extracted.…”

Section: Methodsmentioning

confidence: 99%

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Assessment of success of the Ponseti method of clubfoot management in sub-Saharan Africa: a systematic review

Smythe

Mudariki

Kuper

et al. 2017

BMC Musculoskelet Disord

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BackgroundClubfoot is one of the most common congenital deformities affecting mobility. It leads to pain and disability if untreated. The Ponseti method is widely used for the correction of clubfoot. There is variation in how the result of clubfoot management is measured and reported. This review aims to determine and evaluate how success with the Ponseti method is reported in sub-Saharan Africa.MethodsFive databases were examined in August 2017 for studies that met the inclusion criteria of: (1) evaluation of the effect of clubfoot management; (2) use of the Ponseti method; (3) original study undertaken in sub-Saharan Africa; (4) published between 2000 and 2017. We used the PRISMA statement to report the scope of studies. The included studies were categorised according to a hierarchy of study methodologies and a 27-item quality measure identified methodological strengths and weaknesses. The definition of success was based on the primary outcome reported.ResultsSeventy-seven articles were identified by the search. Twenty-two articles met the inclusion criteria, of which 14 (64%) reported a primary outcome. Outcomes were predominantly reported though case series and the quality of evidence was low. Clinical assessment was the most commonly reported outcome measure and few studies reported long-term outcome. The literature available to assess success of clubfoot management is characterised by a lack of standardisation of outcomes, with different measures reporting success in 68% to 98% of cases.ConclusionWe found variation in the criteria used to define success resulting in a wide range of results. There is need for an agreed definition of good outcome (successful management) following both the correction and the bracing phases of the Ponseti method to establish standards to monitor and evaluate service delivery.Electronic supplementary materialThe online version of this article (10.1186/s12891-017-1814-8) contains supplementary material, which is available to authorized users.

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