The History of Treatment of Congenital Clubfoot at the Royal Liverpool Childrenʼs Hospital

Porat, Shay; Milgrom, C; Bentley, G.

doi:10.1097/01241398-198405000-00009

Cited by 35 publications

(10 citation statements)

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“…Although some studies have reported on pain and function in patients treated with the Ponseti method [1,5,13,22,28] and others have reported on the comprehensive surgical release [1,5,8,9,11,12,17,23,26,29,31,32,35,37], to our knowledge no study has compared these approaches using focused functional and biomechanical analyses, and none has compared quality-of-life measures for patients who had these approaches with those of individuals with normal feet. Such comparisons are important, as the patients treated with these two methods during the 1980s and 1990s are now young adults in the workforce.…”

Section: Introductionmentioning

confidence: 99%

Long-term Results of Comprehensive Clubfoot Release Versus the Ponseti Method: Which Is Better?

Smith

Kuo

Graf

et al. 2014

Clinical Orthopaedics &Amp; Related Research

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Background Clubfoot can be treated nonoperatively, most commonly using a Ponseti approach, or surgically, most often with a comprehensive clubfoot release. Little is known about how these approaches compare with one another at longer term, or how patients treated with these approaches differ in terms of foot function, foot biomechanics, or quality-of-life from individuals who did not have clubfoot as a child. Questions/purposes We compared (1) focused physical and radiographic examinations, (2) gait analysis, and (3) quality-of-life measures at long-term followup between groups of adult patients with clubfoot treated either with the Ponseti method of nonsurgical management or a comprehensive surgical release through a Cincinnati incision, and compared these two groups with a control group without clubfoot. Methods This was a case control study of individuals treated for clubfoot at two separate institutions with different methods of treatment between 1983 to 1987. One hospital used only the Ponseti method and the other mainly used a comprehensive clubfoot release. There were 42 adults (24 treated surgically, 18 treated with Ponseti method) with isolated clubfoot along with 48 healthy control subjects who agreed to participate in a detailed analysis of physical function, foot biomechanics, and quality-of-life metrics. Results Both treatment groups had diminished strength and motion compared with the control subjects on physical examination measures; however, the Ponseti group had significantly greater ankle plantar flexion ROM (p \ 0.001), greater ankle plantar flexor (p = 0.031) and evertor (p = 0.012) strength, and a decreased incidence of osteoarthritis in the ankle and foot compared with the surgical group. During gait the surgical group had reduced peak ankle plantar flexion (p = 0.002), and reduced sagittal plane hindfoot (p = 0.009) and forefoot (p = 0.008) ROM during the preswing phase compared with the Ponseti group. The surgical group had the lowest overall ankle power generation during push off compared with the control subjects (p = 0.002). Outcome tools revealed elevated pain levels in the surgical group compared with the Ponseti group (p = 0.008) and lower scores for physical function and quality-of-life for both clubfoot groups compared with age-range matched control subjects (p = 0.01).

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Section: Introductionmentioning

confidence: 99%

Long-term Results of Comprehensive Clubfoot Release Versus the Ponseti Method: Which Is Better?

Smith

Kuo

Graf

et al. 2014

Clinical Orthopaedics &Amp; Related Research

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“…Recurrence occurs mainly in the hindfoot and is clinically evident by the development of equinus and varus deformities of the heel [4]. Midfoot deformities also may occur during recurrence [20]. Although Ponseti serial casting techniques reportedly achieve lasting correction in 62% to 98% of patients with a 10% relapse rate after initial successful treatment [22], patients with recurrent clubfoot require additional treatment [15].…”

Section: Introductionmentioning

confidence: 99%

Does Short-term Application of an Ilizarov Frame with Transfixion Pins Correct Relapsed Clubfoot in Children?

Refai

Song

2012

Clinical Orthopaedics &Amp; Related Research

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Background Treatment of relapsed clubfoot after soft tissue release in children is difficult because of the high recurrence rate and related complications. Even though the Ilizarov method is used for soft tissue distraction, there is a high incidence of recurrence after removal of the Ilizarov frame owing to previous contracture of soft tissue and a skin scar. Questions/Purposes We asked (1) whether transfixation of midfoot joints by temporary K wires during the consolidation stage after short-term application of an Ilizarov frame would maintain correction of the relapsed clubfoot clinicoradiologically and (2) whether this method would reduce the rate of recurrence and related complications in patients with a skin scar from previous surgery.

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“…Extensive soft-tissue releases frequently provide definitive correction 8,[18][19][20][21][22][23][24] , but they may have short-term complications and up to 47% of patients need additional surgery 16,[25][26][27][28][29][30] . Reported long-term complications include stiffness of the ankle and subtalar joints 13,31,32 , arthritis 13 , muscle weakness 13,31 , pain 13 , and residual deformity 13,31,32 .…”

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confidence: 99%

Long-Term Follow-up of Patients with Clubfeet Treated with Extensive Soft-Tissue Release

Dobbs

Nunley

Schoenecker

2006

The Journal of Bone & Joint Surgery

221

187

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The History of Treatment of Congenital Clubfoot at the Royal Liverpool Childrenʼs Hospital

Cited by 35 publications

References 0 publications

Long-term Results of Comprehensive Clubfoot Release Versus the Ponseti Method: Which Is Better?

Long-term Results of Comprehensive Clubfoot Release Versus the Ponseti Method: Which Is Better?

Does Short-term Application of an Ilizarov Frame with Transfixion Pins Correct Relapsed Clubfoot in Children?

Long-Term Follow-up of Patients with Clubfeet Treated with Extensive Soft-Tissue Release

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