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Mid-term results of a physiotherapist-led Ponseti service for the management of non-idiopathic and idiopathic clubfoot
BACKGROUND: The Ponseti method is the preferred treatment for idiopathic clubfoot. Although popularised by orthopaedic surgeons it has expanded to physiotherapists and other health practitioners. This study reviews the results of a physiotherapist-led Ponseti service for idiopathic and non-idiopathi...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4486504/ https://www.ncbi.nlm.nih.gov/pubmed/26072327 http://dx.doi.org/10.1007/s11832-015-0658-8 |
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author | Dunkley, Mia Gelfer, Yael Jackson, Debbie Parnell, Evette Armstong, Jennifer Rafter, Cristina Eastwood, Deborah M. |
author_facet | Dunkley, Mia Gelfer, Yael Jackson, Debbie Parnell, Evette Armstong, Jennifer Rafter, Cristina Eastwood, Deborah M. |
author_sort | Dunkley, Mia |
collection | PubMed |
description | BACKGROUND: The Ponseti method is the preferred treatment for idiopathic clubfoot. Although popularised by orthopaedic surgeons it has expanded to physiotherapists and other health practitioners. This study reviews the results of a physiotherapist-led Ponseti service for idiopathic and non-idiopathic clubfeet and compares these results with those reported by other groups. METHOD: A prospective cohort of clubfeet (2005–2012) with a minimum 2-year follow-up after correction was reviewed. Physiotherapists treated 91 children—41 patients (69 feet) had non-idiopathic deformities and 50 children (77 feet) were idiopathic. Objective outcomes were evaluated and compared to results from other groups managing similar patient cohorts. RESULTS: The mean follow-up was 4.6 years (range 2–8.3 years) for both groups. The non-idiopathic group required a median of 7 casts to correct the clubfoot deformity with an 83 % tenotomy rate compared to a median of 5 casts for the idiopathic group with a 63 % tenotomy rate. Initial correction was achieved in 96 % of non-idiopathic feet and in 100 % of idiopathic feet. Recurrence requiring additional treatment was higher in the non-idiopathic group with 40 % of patients (36 % of feet) sustaining a relapse as opposed to 8 % (6 % feet) in the idiopathic group. Surgery was required in 26 % of relapsed non-idiopathic feet and 6 % of idiopathic. CONCLUSIONS: Although Ponseti treatment was not as successful in non-idiopathic feet as in idiopathic feet, deformity correction was achieved and maintained in the mid-term for the majority of feet. These results compare favourably to other specialist orthopaedic-based services for Ponseti management of non-idiopathic clubfeet. LEVEL OF EVIDENCE: Prognostic Level III. |
format | Online Article Text |
id | pubmed-4486504 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-44865042015-07-02 Mid-term results of a physiotherapist-led Ponseti service for the management of non-idiopathic and idiopathic clubfoot Dunkley, Mia Gelfer, Yael Jackson, Debbie Parnell, Evette Armstong, Jennifer Rafter, Cristina Eastwood, Deborah M. J Child Orthop Original Clinical Article BACKGROUND: The Ponseti method is the preferred treatment for idiopathic clubfoot. Although popularised by orthopaedic surgeons it has expanded to physiotherapists and other health practitioners. This study reviews the results of a physiotherapist-led Ponseti service for idiopathic and non-idiopathic clubfeet and compares these results with those reported by other groups. METHOD: A prospective cohort of clubfeet (2005–2012) with a minimum 2-year follow-up after correction was reviewed. Physiotherapists treated 91 children—41 patients (69 feet) had non-idiopathic deformities and 50 children (77 feet) were idiopathic. Objective outcomes were evaluated and compared to results from other groups managing similar patient cohorts. RESULTS: The mean follow-up was 4.6 years (range 2–8.3 years) for both groups. The non-idiopathic group required a median of 7 casts to correct the clubfoot deformity with an 83 % tenotomy rate compared to a median of 5 casts for the idiopathic group with a 63 % tenotomy rate. Initial correction was achieved in 96 % of non-idiopathic feet and in 100 % of idiopathic feet. Recurrence requiring additional treatment was higher in the non-idiopathic group with 40 % of patients (36 % of feet) sustaining a relapse as opposed to 8 % (6 % feet) in the idiopathic group. Surgery was required in 26 % of relapsed non-idiopathic feet and 6 % of idiopathic. CONCLUSIONS: Although Ponseti treatment was not as successful in non-idiopathic feet as in idiopathic feet, deformity correction was achieved and maintained in the mid-term for the majority of feet. These results compare favourably to other specialist orthopaedic-based services for Ponseti management of non-idiopathic clubfeet. LEVEL OF EVIDENCE: Prognostic Level III. Springer Berlin Heidelberg 2015-06-14 2015-06 /pmc/articles/PMC4486504/ /pubmed/26072327 http://dx.doi.org/10.1007/s11832-015-0658-8 Text en © The Author(s) 2015 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. |
spellingShingle | Original Clinical Article Dunkley, Mia Gelfer, Yael Jackson, Debbie Parnell, Evette Armstong, Jennifer Rafter, Cristina Eastwood, Deborah M. Mid-term results of a physiotherapist-led Ponseti service for the management of non-idiopathic and idiopathic clubfoot |
title | Mid-term results of a physiotherapist-led Ponseti service for the management of non-idiopathic and idiopathic clubfoot |
title_full | Mid-term results of a physiotherapist-led Ponseti service for the management of non-idiopathic and idiopathic clubfoot |
title_fullStr | Mid-term results of a physiotherapist-led Ponseti service for the management of non-idiopathic and idiopathic clubfoot |
title_full_unstemmed | Mid-term results of a physiotherapist-led Ponseti service for the management of non-idiopathic and idiopathic clubfoot |
title_short | Mid-term results of a physiotherapist-led Ponseti service for the management of non-idiopathic and idiopathic clubfoot |
title_sort | mid-term results of a physiotherapist-led ponseti service for the management of non-idiopathic and idiopathic clubfoot |
topic | Original Clinical Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4486504/ https://www.ncbi.nlm.nih.gov/pubmed/26072327 http://dx.doi.org/10.1007/s11832-015-0658-8 |
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