Vergleich der Behandlungsergebnisse bei kongenitalen idiopathischen und nichtidiopathischen Klumpfüßen

Funk, Julia F.; Lebek, Susanne; Seidl, Tamara; Placzek, Richard

doi:10.1007/s00132-012-1982-z

Cited by 16 publications

(7 citation statements)

References 16 publications

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“…According to our results, recurrence was observed in 16.3% of cases with idiopathic clubfoot and 45.8% of non-idiopathic clubfoot subjects ( P = 0.001). These results are in line with the report of Gelfer et al[ 25 ] and contrary to the study by Funk et al[ 11 ] which showed no significant difference in recurrence rate between idiopathic and non-idiopathic congenital clubfeet treated using the Ponseti method. In that study, treatment of non-idiopathic cases started later and took longer than idiopathic clubfoot patients.…”

Section: Discussionsupporting

confidence: 90%

“…For decades, extensive complex surgical release procedures had been the main treatment of clubfoot without acceptable long-term outcomes[ 6 , 7 ] till Ponseti published the significant result of a gentle serial manipulation and casting method to correct the deformities of clubfoot including forefoot adduction, hindfoot varus, equinus, and cavus[ 2 , 8 ]. To date, the Ponseti method is widely accepted as the gold standard for treatment of all clubfeet, regardless of the type and etiology around the world in children of 1 to 9 years of age[ 9 - 11 ]. The efficiency of the popular Ponseti method in correcting clubfoot has been well established.…”

Section: Introductionmentioning

confidence: 99%

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Factors associated with recurrence of clubfoot treated by the Ponseti method

Azarpira

Emami

Vosoughi

et al. 2016

WJCC

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AIMTo assess several associated factors on the recurrence of clubfoot after successful correction by the Ponseti method.METHODSA total of 115 children with 196 clubfeet deformities, treated by the Ponseti method, were evaluated. Demographic data, family history of clubfoot in first-degree relatives, maternal educational level and brace compliance were enquired. Based on their medical files, the characteristics of the patients at the time of presentation such as age, possible associated neuromuscular disease or especial syndrome, severity of the deformity according to the Dimeglio grade and Pirani score, residual deformity after previous Ponseti method and number of casts needed for the correction were recorded.RESULTSThere were 83 boys (72.2%) and 32 girls (27.8%) with a male to female ratio of 2.6. The mean age at the initiation of treatment was 5.4 d (range: 1 to 60 d). The average number of casts applied to achieve complete correction of all clubfoot deformities was 4.2. Follow-up range was 11 to 60 mo. In total, 39 feet had recurrence with a minimum Dimeglio grade of 1 or Pirani score of 0.5 at the follow-up visit. More recurrence was observed in non-idiopathic clubfoot deformities (P = 0.001), non-compliance to wear braces (P < 0.001), low educational level of mother (P = 0.033), increased number of casts (P < 0.001), and more follow-up periods (P < 0.001). No increase in the possibility of recurrence was observed when the previous unsuccessful casting was further treated using the Ponseti method (P = 0.091). Also, no significant correlation was found for variables of age (P = 0.763), Dimeglio grade (P = 0.875), and Pirani score (P = 0.624) obtaining at the beginning of the serial casting.CONCLUSIONUsing the Ponseti method, non-idiopathic clubfoot, non-compliance to wear braces, low educational level of mother, increased number of casts and more follow-up periods had more association to possible increase in recurrence rate after correction of clubfoot deformity.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Factors associated with recurrence of clubfoot treated by the Ponseti method

Azarpira

Emami

Vosoughi

et al. 2016

WJCC

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“…6,20 Despite these difficulties, the Ponseti method is still being used as a first-line treatment for non-idiopathic CTE, and good outcomes have been reported. 6,[21][22][23][24][25]…”

Section: Non-idiopathic Ctevmentioning

confidence: 99%

Results of Ponseti Casting for Clubfoot in a Tertiary Public Hospital

Eusebio¹,

Sumpaico²

2021

Acta Med Philipp

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Introduction. Congenital talipes equinovarus (CTEV), also called clubfoot, is one of the most common orthopedic congenital anomalies. However, there is no formal study of the condition here in the Philippines, and data is sparse regarding the epidemiology, treatment, and outcomes in similar third-world countries. Methods. Retrospective review of data of clubfoot patients seen at the Philippine General Hospital (PGH) Clubfoot Clinic from 2006 up to the present. Results. Records from 75 patients treated at the PGH Clubfoot Clinic from 2010-2016 were reviewed. Idiopathic clubfoot comprised 76% of the patients, while syndromic clubfoot comprised 24%. A good outcome of the Ponseti method was seen in 82% and 88% of the idiopathic and syndromic clubfoot patients, respectively. Idiopathic clubfoot cases that had good outcomes required an average of 11.84 casts to tenotomy or bracing, which was not statistically significant compared to 9.55 average sessions for syndromic clubfoot (p=0.21). The initial Pirani scores for both cases were not significantly different (p=0.95). Idiopathic cases with poor outcomes needed less casting sessions (4.45) because the decision to operate was made early. Age was not found to significantly affect the outcome of treatment for idiopathic clubfoot (p=0.20) and syndromic clubfoot (p=0.64). Conclusion. Ponseti casting was found to be effective in treating both idiopathic and syndromic clubfoot patients. The number of sessions did not differ significantly between the two.

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“…Mehrere Studien haben bis zum heutigen Zeitpunkt gezeigt, dass es möglich ist, auch bei Grunderkrankungen wie Spina bifida, Arthrogrypose und verschiedenen mit Klumpfüßen assoziierten Syndromen eine initiale Behandlung nach dem Ponseti-Konzept erfolgreich durchzuführen [40][41][42][43]. Ebenso ist es möglich, vernachlässigte oder bereits operierte Klumpfüße nach Ponseti zu behandeln.…”

Section: Ponseti Bei Sekundären/ Nicht Idiopathischen Klumpfüßenunclassified

Klumpfußtherapie nach Ponseti – aktueller Standard

Funk

Lebek

2018

Z Orthop Unfall

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ZusammenfassungIn dieser Übersicht wird die Klumpfußbehandlung unter besonderer Berücksichtigung der von Ponseti entwickelten konservativen Methode dargestellt. Im Kontext der verfügbaren Literatur werden die pathoanatomischen Grundlagen, die zu der Entwicklung der einfachen Korrekturhandgriffe führten, beschrieben. Die Auswirkungen der verschiedenen Ruhigstellungsmaterialien auf das Behandlungsergebnis werden ebenso beleuchtet wie die Probleme bei der Abduktionsschienentherapie. Weiterhin werden das Erkennen von Rezidiven und das von Ponseti entwickelte Konzept zur Rezidivbehandlung erörtert. Dass die Methode sich zum weltweiten Goldstandard entwickelt hat, belegen neben der globalen Verbreitung auch in Ländern mit geringem Einkommen Untersuchungen, die zeigen, dass sie auch bei nicht idiopathischen, vernachlässigten und voroperierten Klumpfüßen gute initiale Ergebnisse bewirkt. In verschiedenen Untersuchungen wurde auch mit instrumenteller Bewegungsanalyse gezeigt, dass konservativ behandelte Klumpfüße deutlich besser funktionieren, weil sie weniger arthrotische Veränderungen und Schmerzen zeigen als ausgedehnt operierte. Diese Informationen sind für den Behandler nicht nur nützlich bei der pränatalen Beratung hinsichtlich der besten verfügbaren Therapie, sondern helfen auch, die Compliance der Eltern bei der mehrjährigen Abduktionsschienenbehandlung hoch zu halten. Zu diesem Zweck wird auch der Vergleich zur konservativen physiotherapeutischen bzw. französischen Methode gezogen. Abschließend wird der Forschungsstand hinsichtlich der genetischen Ursachen der Klumpfußentwicklung beleuchtet.

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Vergleich der Behandlungsergebnisse bei kongenitalen idiopathischen und nichtidiopathischen Klumpfüßen

Abstract: This study shows good initial results after Ponseti treatment for idiopathic as well as non-idiopathic clubfeet. Based on the good functional results all clubfeet should initially be treated with the Ponseti method regardless of the etiology.

Cited by 16 publications

References 16 publications

Factors associated with recurrence of clubfoot treated by the Ponseti method

Factors associated with recurrence of clubfoot treated by the Ponseti method

Results of Ponseti Casting for Clubfoot in a Tertiary Public Hospital

Klumpfußtherapie nach Ponseti – aktueller Standard

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