Management of congenital talipes equinovarus using the Ponseti method

Jowett, Charlie; Morcuende, José A.; Ramachandran, Manoj

doi:10.1302/0301-620x.93b9.26947

Cited by 133 publications

(99 citation statements)

References 70 publications

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“…The Ponseti treatment provides, in over 95 % of the cases, a foot which is completely functional and pain free when started before the walking age; however, most of the studies with this high amount of successful treatment are from industrialized countries [1,2]. In the English literature there are numerous examples present of successful introduction of the Ponseti method in the low-and middle-income setting [3][4][5][6]. Given the relatively simple and highly cost-effective treatment, the question arises as to why neglected clubfoot still exists.…”

Section: Introductionmentioning

confidence: 99%

Feasibility and barriers of treating clubfeet in four countries

Wijck

Oomen²,

Heide

2015

International Orthopaedics (SICOT)

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Purpose The purpose of this study was to elucidate why neglected clubfeet still exists despite the availability of a highly (cost)-effective treatment-the Ponseti treatment. Methods A qualitative and partly quantitative study with semi-structured interviews was conducted in four countries: the Netherlands, South Africa, Argentina and Indonesia with both caregivers, mostly parents, of children with clubfoot and practitioners treating clubfoot. The topics discussed with the caregivers (n=51) were the conceptions of the cause of clubfeet, received information, accessibility, financial aspects, and social stigma. With the practitioners (n=11) the focus of the interviews was the treatment protocol and finance. Results Several barriers towards the start of the treatment were highlighted. At all places treatment was financed by the government, insurance or charity. Nevertheless, the cost of transport and missed working days formed a barrier, although there is a large difference between and within countries. Poverty, long travel duration, and beliefs of supernatural causes for the clubfoot result in delay in the start of treatment. Conclusion These are problems we need to address when making effective treatment available for every child to diminish the burden of neglected clubfoot; especially accessible clinics in rural areas can be a good alternative to highly specialized hospitals in large cities. We as a community should try to find and overcome the barriers to treat these patients, because we have a relatively easy and highly costeffective treatment option which can be given by trained nonphysicians supervised by an interested medical doctor.

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Section: Introductionmentioning

confidence: 99%

Feasibility and barriers of treating clubfeet in four countries

Wijck

Oomen²,

Heide

2015

International Orthopaedics (SICOT)

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“…Uncertainty can also manifest because of the relapses that may occur after treatment [12-14]. Furthermore, available clubfoot treatment options vary and their efficacy depends on the experience of the health care provider [15-17]. Due to the limited time available for consultation with health care professionals and the relative rarity of the condition, caregivers may be likely to turn to online support communities to manage their illness-related uncertainty.…”

Section: Introductionmentioning

confidence: 99%

Online Information Exchanges for Parents of Children With a Rare Health Condition: Key Findings From an Online Support Community

Oprescu¹,

Campo²,

Lowe³

et al. 2013

J Med Internet Res

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BackgroundThe Internet provides new opportunities for parents of children with difficult illnesses and disabilities to find information and support. The Internet is particularly important for caregivers of children with special needs due to numerous health-related decisions they face. For at-risk populations, online support communities can become key settings and channels for health promotion and communication.ObjectiveThis study is an initial exploration of the information-seeking and information-provision processes present in an online support community, which is an area of opportunity and interest for Internet-based medical research and practice. The aim of this study was to explore and describe information-related processes of uncertainty management in relationship to clubfoot. Specifically, the study explored interpersonal communication (information seeking and provision) in an online support community serving the needs of parents of children with clubfoot.MethodsThe study population consisted of messages posted to an online community by caregivers (parents) of children with clubfoot. The theoretical framework informing the study was the Uncertainty Management Theory (UMT). The study used content analysis to explore and categorize the content of 775 messages.ResultsWomen authored 664 of 775 messages (86%) and men authored 47 messages (6%). Caregivers managed uncertainty through information seeking and provision behaviors that were dynamic and multilayered. The ratio of information-seeking messages to information-provision responses was 1 to 4. All five types of information-seeking behaviors proposed by Brashers’ schema were identified, most of them being correlated. Information seeking using direct questions was found to be positively correlated to self-disclosure (r=.538), offering of a candidate answer (r=.318), and passive information seeking (r=.253). Self-disclosure was found to be positively correlated to provision of a candidate answer (r=.324), second-guessing (r=.149), and passive information seeking (r=.366). Provision of a candidate answer was found to be positively correlated with second-guessing (r=.193) and passive information seeking (r=.223). Second-guessing was found to be positively correlated to passive information seeking (r=.311). All correlations reported above were statistically significant (P<0.01). Of the 775 messages analyzed, 255 (33%) identified a medical professional or institution by name. Detailed medical information was provided in 101 (13%) messages, with the main source of information identified being personal experience rather than medical sources.ConclusionOnline communities can be an effective channel for caregivers, especially women, to seek and offer information required for managing clubfoot-related uncertainty. To enhance communication with parents, health care institutions may need to invest additional resources in user-friendly online information sources and online interactions with caregivers of children with special illnesses such as clubfoot. Furthermore, explora...

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“…However, the dorsiflexion angle at the final follow-up was still significantly higher than that before the splinting (P <0.001). Despite the theoretical advantages of using the functional splint for achieving good dorsiflexion described in previous papers [1][2][3][4][5], we believe that no researchers have reported a significant difference between the angles of dorsiflexion before and after splinting. This is the first study to show the clinical efficacy of a functional splint in the treatment of dorsiflexion in severe congenital clubfoot.…”

Section: Discussionmentioning

confidence: 78%

“…Currently, there is agreement that functional splints such as the Denis-Browne splint can be used to maintain corrections obtained after proper initial treatment including gentle manipulation and serial casting [1][2][3][4][5]. However, maintenance of the correction of clubfoot deformity, particularly equinus, is considered to be very difficult.…”

Section: Introductionmentioning

confidence: 99%

Conservative treatment of severe clubfoot using a novel functional dynamic splint

Adachi

Fukuhara²,

Nakasa

et al. 2015

Journal of Pediatric Orthopaedics B

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Forty-six severe clubfeet in 29 patients were treated by serial castings, followed by a newly developed dynamic splint. The mean period of splint usage was 59.9 months and the mean period of follow-up was 81.5 months. Of the patients, 76.1% were satisfied, 87.0% had no functional deficit, and 84.8% had no pain. Radiographical evaluation showed good correction. The mean dorsiflexion angle was -0.8° at the end of cast treatment and 13.6° at the time of the final follow-up. This study clearly showed the effectiveness of a functional dynamic splint for the correction of equinus in cases of severe clubfoot.

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Management of congenital talipes equinovarus using the Ponseti method

Cited by 133 publications

References 70 publications

Feasibility and barriers of treating clubfeet in four countries

Feasibility and barriers of treating clubfeet in four countries

Online Information Exchanges for Parents of Children With a Rare Health Condition: Key Findings From an Online Support Community

Conservative treatment of severe clubfoot using a novel functional dynamic splint

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