The Ponseti method for the treatment of congenital club foot: review of the current literature and treatment recommendations

Radler, C

doi:10.1007/s00264-013-2031-1

Cited by 107 publications

(101 citation statements)

References 71 publications

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“…Clubfoot is a three-dimensional musculoskeletal deformity characterized by equinus, hindfoot varus, and forefoot adductus and cavus [25]. In ambulatory children, the deformity causes the child to walk on the lateral border and when severe, the dorsum of their foot.…”

Section: Discussionmentioning

confidence: 99%

“…Conservative treatment attempts to correct the deformity such that the foot is functional, pain-free, flexible, and able to fit in regular shoes [22,23]. The Ponseti method has become the gold standard in isolated clubfoot care [7,20,25]. This approach consists of specific serial manipulations, casting and tenotomy of the Achilles tendon, followed by abduction bracing of the affected foot or feet until the child is 2 to 4 years old.…”

Section: Introductionmentioning

confidence: 99%

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Does Strict Adherence to the Ponseti Method Improve Isolated Clubfoot Treatment Outcomes? A Two-institution Review

Miller

Carry

Mark

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Does Strict Adherence to the Ponseti Method Improve Isolated Clubfoot Treatment Outcomes? A Two-institution Review

Miller

Carry

Mark

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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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].…”

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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“…Te patient was treated immediately after removal of the former cast and the new one was applied within one hour, as suggested by Radler [13].…”

Section: The Casementioning

confidence: 99%

Extracorporeal Shock Waves in the Treatment of Equinovarus Foot in a Duchenne Patient: A Case Report

Barazzuol¹,

Lampropoulou²,

Meneghini³

et al. 2015

J Nov Physiother Phys Rehabil

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Background: Duchenne muscular dystrophy (DMD) is characterized by a progressive muscular weakness, with loss of independent ambulation. When the disease results in the complete loss of ambulation, one of the purposes of treatment during the latest phase is to prevent or reduce complications such as foot deformities.A 20-year-old DMD patient had a complete loss of muscular strength in the inferior and superior limbs and a severe bilateral clubfoot deformity. Active movements were not possible, while passive motion was very limited in dorsiflexion and pronation, inversion and eversion, with stronger limitation on the right foot.First, the patient was treated with gentle manipulation and casting for two weeks, but no improvement in passive range of motion was detected.The treatment was then modified by adding a session of focused extracorporeal shock wave therapy for five consecutive weeks. Results:After five shock wave sessions, both limbs showed a bilateral correction of the talometatarsal angle, respectively 26° on the right and 19° on the left foot. The most relevant improvements were estimated in the passive dorsiflexion of both ankles: with a gentle manipulation, both feet could return to the anatomical position, in such a way to allow the patient to wear his own shoes. Conclusions:There is increasing evidence that nitric oxide (NO) and vascular endothelial growth factor (VEGF) dysregulation is involved in DMD progression; on the other hand, extracorporeal shock wave therapy (ESWT) induces NO and VEGF production, thus promoting angiogenesis, and has proven effective in reducing muscular hypertone. ESWT shows a potential role in the treatment of Duchenne complications such as foot deformities, as part of a multidisciplinary rehabilitation program.of their antagonist muscle tendons 6 . When ambulation is no longer possible, the rehabilitation program focuses on the prevention or reduction of complications and deformities, in order to alleviate pain and pressure, to allow the patient to wear shoes, and to correctly place the feet on wheelchair footrests [7].Despite the absence of a specific treatment, the natural history of the DMD can be in part modified [1].Since the surgical therapy showed controversial results on long term effectiveness, there has been a growing consideration on the conservative approach, including drugs and rehabilitation. Nevertheless, in most studies the rehabilitation programme includes stretching, eccentric and aerobic exercise, sub maximum strengthening activity when residual strength is higher, while few authors emphasize the role of physical energies, like whole-body vibration [8,9] and laser therapy [10].Extracorporeal shock wave therapy (ESWT) is a relatively recent method used in the treatment of many musculoskeletal disorders, such as tendinopathies and non-union fractures.Over the past few years, ESWT has received a widespread consensus in many other fields, including in the treatment of spastic hypertone in patients affected by stroke: even a single session of shock

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The Ponseti method for the treatment of congenital club foot: review of the current literature and treatment recommendations

Cited by 107 publications

References 71 publications

Does Strict Adherence to the Ponseti Method Improve Isolated Clubfoot Treatment Outcomes? A Two-institution Review

Does Strict Adherence to the Ponseti Method Improve Isolated Clubfoot Treatment Outcomes? A Two-institution Review

Feasibility and barriers of treating clubfeet in four countries

Extracorporeal Shock Waves in the Treatment of Equinovarus Foot in a Duchenne Patient: A Case Report

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