Treatment Results of Late-relapsing Idiopathic Clubfoot Previously Treated With the Ponseti Method

McKay, Scott; Dolan, Lori A.; Morcuende, José A.

doi:10.1097/bpo.0b013e318256117c

Cited by 39 publications

(22 citation statements)

References 19 publications

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“…They found a subsequent relapse after tibialis anterior tendon transfer in 15 % of feet (ten patients with 15 club feet) [72]. The results of the treatment of relapse were evaluated in another study and it was observed that at an average age at final follow-up of 23.3 years (range eight to 50.6 years) 90 % of patients wore regular shoes, 41 % had pain with activities, but only 18 % were limited in function by their feet [73].…”

Section: Results Of Treatmentmentioning

confidence: 99%

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

Radler

2013

International Orthopaedics (SICOT)

107

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The Ponseti method has become the gold standard of care for the treatment of congenital club foot. Despite numerous articles in MEDLINE reporting results from around the globe there are still crucial details of the Ponseti method which seem to be less commonly known or considered. The Ponseti method is not only a detailed method of manipulation and casting but also of preventing and treating relapse. Recommendations on how to correct complex club foot have resulted in an almost 100 % initial correction rate. The foot abduction brace is crucial for preventing relapse and is still a challenge for families and sometimes doctors alike. Experience and knowledge on how to support the parents, how to set and apply the brace in the best possible way and how to solve problems that can be encountered during the bracing period are essential to ensure compliance. Regular follow-up visits are necessary to be able to detect early signs of recurrence and prevent full relapse by enforcing abduction bracing, recasting or performing tibialis anterior tendon transfer. Recent midterm outcome studies have shown that by following the Ponseti treatment regime in all aspects it is possible to prevent open joint surgery in almost all cases. The body of literature of the last decade has evaluated many steps and aspects of the Ponseti method and gives valuable answers to questions encountered in daily practice. This review of the current literature and recommendations on the different aspects of the Ponseti method aims to promote understanding of the treatment regime and its' details.

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Section: Results Of Treatmentmentioning

confidence: 99%

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

Radler

2013

International Orthopaedics (SICOT)

107

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“…Given its visual nature, with one or both feet turned inwards at birth, clubfoot can be a major source of uncertainty for the parents of the children affected after diagnosis and during treatment [5,11]. 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].…”

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, some deformities remain resistant to conservative treatment, even for trained and specialized teams. Bad outcomes depend on multifactorial parameters [ 3 , 10 , 34 – 36 ].…”

Section: Discussionmentioning

confidence: 99%

Medial to posterior release procedure after failure of functional treatment in clubfoot: A prospective study

Bocahut

Simon

Mazda

et al. 2016

Journal of Children's Orthopaedics

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PurposeTwo conservative techniques for clubfoot treatment are still being debated and depend upon the institution’s expertise. For >40 years, the current institution has been a pioneer in the development of the physiotherapy method; however, some severe deformities remain resistant to this method which causes pain, sprains, and difficulties wearing shoes. Therefore, a surgical approach was developed simultaneously for the treatment of these residual or recurring clubfeet. The procedure reproduces the same chronological steps by performing forefoot derotation before correcting hindfoot equinus. The aim of the current study was to assess the results of this surgical technique.MethodsAll clubfeet undergoing surgery between October 1995 and February 2009 were prospectively included. Initial severity was based on Dimeglio’s classification and final outcomes on the International Clubfoot Study Group (ICFSG) outcome evaluation system. Last follow-up results were assessed by physical examination and radiographs.ResultsA total of 137 patients with severe clubfeet (mean Dimeglio score 12.0) underwent surgery. At the mean follow-up of 10.8 years, mean ICFSG score was 4.3 (range 0–23), and 12 % required revision surgery. The rate of undercorrection and overcorrection was low (17 pes-plano-valgus ft and 11 ft with undercorrection). Eight feet had a fixed deformity.ConclusionsSevere deformities are more resistant to conservative techniques even for institutions with large experience. These deformities require further treatment, including surgery if necessary. The medial to posterior soft-tissue release is a valuable technique with stable results.Level of evidenceLevel IV.

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Treatment Results of Late-relapsing Idiopathic Clubfoot Previously Treated With the Ponseti Method

Abstract: Therapeutic level IV.

Cited by 39 publications

References 19 publications

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

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

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

Medial to posterior release procedure after failure of functional treatment in clubfoot: A prospective study

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